MEDICARE: MRS. GRETCHEN GARCIA GRIERSON MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0717	NV

General Provider Information

NPI Number	:	1538265368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GRETCHEN GARCIA GRIERSON MFT

Provider Business Mailing Address
First Line	:	1481 W WARM SPRINGS RD
Second Line	:	SUITE 132
City	:	HENDERSON
State	:	NV
Zip	:	89014-7633
Country	:	US
Telephone Number	:	702-568-5888
Fax Number	:	702-568-7554

Provider Business Practice Location Address
First Line	:	1481 W WARM SPRINGS RD
Second Line	:	SUITE 132
City	:	HENDERSON
State	:	NV
Zip	:	89014-7633
Country	:	US
Telephone Number	:	702-568-5888
Fax Number	:	702-568-7554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	04/05/2017

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