Provider Information for 1629635727
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LORENA GRIESE LMFTA
Sex: Female
NPI: 1629635727
Last Updated: 2019-05-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1629635727 | ||||||||
| Enumeration Date | 2019-05-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 755 S TELSHOR BLVD STE Q102 LAS CRUCES, NM 88011-4681 United States Phone: 575-888-4666 | Fax:888-473-9160 | ||||||||
| Primary Practice Address | 755 S TELSHOR BLVD STE Q102 LAS CRUCES, NM 88011-4681 United States Phone: 575-888-4666 | Fax:888-473-9160 | ||||||||
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