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NPI 1396056990

NPI 1396056990 : PATRICIA ANN CHOUDHARY-GRIGLEY LPC, LAC : GRAND JUNCTION, CO

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General NPI Number Information
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    NPI Number           |    1396056990
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICIA ANN CHOUDHARY-GRIGLEY LPC, LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/29/2010
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    Last Update Date     |    11/03/2022
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Provider Practice Location Address
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    Address Line         |    300 MAIN ST STE 201 
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    City                 |    GRAND JUNCTION
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    State                |    CO
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    Zip                  |    81501-2404
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    Country              |    US
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    Telephone            |    970-462-9581
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2040 SANDALWOOD CT 
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    City                 |    GRAND JUNCTION
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    State                |    CO
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    Zip                  |    81506-4835
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    Country              |    US
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    Telephone            |    970-433-1584
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    ACD.0000545
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    License Number State |    CO
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    LPC.0013424
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    License Number State |    CO
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