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General NPI Number Information
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NPI Number | 1821737032
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Entity Type | Organization
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Legal Business Name | GRISELDA PATTILLO, LCSW PLLC
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Dates
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Enumeration Date | 06/04/2022
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 1006 S ROCK ST
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City | GEORGETOWN
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State | TX
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Zip | 78626-5837
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Country | US
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Telephone | 512-200-7291
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 4000
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 512-200-7291
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | GRISELDA ONOFRE PATTILLO
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Credential | LCSW
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Telephone | 832-621-6570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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