BEN GRAYWOLF

ALBUQUERQUE, NM
NPI1760563001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  OO79341)
Enumeration Date2006-10-17
Last Update Date2007-07-08
Business Address
Mr. BEN GRAYWOLF
1217 1ST ST NW
ALBUQUERQUE, NM 87102-1529
Phone number: 505-344-6738
Mailing Address
Mr. BEN GRAYWOLF
1111 CARDENAS DR SE APT # 316
ALBUQUERQUE, NM 87108-4736
Phone number: 505-338-8027