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Individual

FATIMA A GRANADOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3452
(575) 347-5177
Mailing address
72 GAIL HARRIS ST, ROSWELL, NM 88203-8116
(575) 347-3452
(575) 347-5177

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0175451
NM
104100000X
Social Worker
Primary
M-10239
NM

Other

Enumeration date
08/15/2012
Last updated
09/10/2021
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