Individual
MARILYN LORRAINE GRAYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
3636 MENAUL BLVD NE, SUITE 206, ALBUQUERQUE, NM 87110-2871
(505) 255-5905
Mailing address
3636 MENAUL BLVD NE, SUITE 206, ALBUQUERQUE, NM 87110-2871
(505) 255-5905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
643
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z6156
—
NM
Enumeration date
08/13/2006
Last updated
07/08/2007
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