Individual
MS. MELISSA JO GROSKREUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
342 BELGRADE AVE, NORTH MANKATO, MN 56003-3804
(507) 388-3181
(507) 388-3199
Mailing address
3756 210TH AVE, WELLS, MN 56097-3205
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4018
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620220900
—
MN
Enumeration date
07/06/2006
Last updated
03/17/2018
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