Individual
MRS. ERIKA GRUSSENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 W 4TH ST, PORTALES, NM 88130-6306
(575) 519-0777
Mailing address
PO BOX 433, TEXICO, NM 88135-0433
(575) 519-0777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-10904
NM
Other
Enumeration date
11/24/2019
Last updated
11/24/2019
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