| Doctor Name: | MR. JOE ROBERT GRIST |
| NPI Number: | 1275664575 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED, LPC, LCDC |
| License Number: | 5495 |
| Business Practice Address: | 7 Morningside Drive Andrews, TX - 797143903 |
| Business Phone Number: | 4325235493 |
| Business Fax Number: | 4325236719 |
| Mailing Address: | 7 Morningside Drive, ANDREWS |
| State: | TX |
| Postal Code: | 797143903 |
| Phone Number: | 4325235493 |
| Fax Number: | 4325236719 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 01/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 5495 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |