=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326985375
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BIANCA GRAMBO LBSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2026
-----------------------------------------------------
Last Update Date | 04/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 S HUDSON ST STE 8
-----------------------------------------------------
City | SILVER CITY
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88061-6184
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-694-5478
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 203 CUPRITE ST
-----------------------------------------------------
City | TYRONE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88065-5500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-480-0991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | SWB-2026-0053
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------