Individual
ELIZABETH A GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 820-6333
Mailing address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 820-6333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0131311
NM
Other
Enumeration date
05/17/2010
Last updated
11/19/2012
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