Individual
BEATRIZ CAROLINA GRULLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4797
Mailing address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4797
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
WY
101YM0800X
Mental Health Counselor
—
WI
101YP2500X
Professional Counselor
Primary
LPC-2054
WY
101YP2500X
Professional Counselor
LPC.0018508
CO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/20/2017
Last updated
06/15/2023
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