Individual
CAROLE ANNE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1570 W PICACHO AVE, LAS CRUCES, NM 88005-2375
(575) 202-7576
Mailing address
145 ROBERTS DR, LAS CRUCES, NM 88005-3073
(575) 202-7576
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1944
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59482788
—
NM
Enumeration date
06/15/2009
Last updated
07/21/2022
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