Individual
KEANNA GROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 MAIN AVE, FARGO, ND 58103-6811
(218) 849-0684
Mailing address
217 21ST AVE N, FARGO, ND 58102-2016
(218) 849-0684
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/07/2020
Last updated
05/07/2020
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