Individual
MARY LEE ROSKE-GROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, LADC
Contact information
Practice address
410 CHURCH ST SE, BOYNTON HEALTH SERVICE, MINNEAPOLIS, MN 55455-0340
(612) 624-1444
(612) 625-7155
Mailing address
410 CHURCH ST SE, MINNEAPOLIS, MN 55455-0340
(612) 624-7172
(612) 625-1434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
300299
MN
1041C0700X
Clinical Social Worker
Primary
14998
MN
Other
Enumeration date
11/13/2006
Last updated
08/25/2010
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