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Contact Information

GAYLA K GRISHAM, LBSW
421 VILLA DRIVE #209
WACO, TX76710
 Phone: 254-405-2702
 Fax: 866-686-9651
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
 

Case Management

251B00000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for GAYLA K GRISHAM · (Female)

NPI Number 1114058245
Status Active
Credentials LBSW
Entity Individual
Enumeration date 03/08/2007
Last updated 07/20/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 33966
  • TX Medicaid 182404701
  • TX Medicaid 182405401
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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