Individual
MS. RENEE MICHELLE GRUSSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1010 2ND AVE S, FARGO, ND 58103-8226
(701) 239-6705
(701) 241-5775
Mailing address
PO BOX 3106, FARGO, ND 58108-3106
(701) 239-6705
(701) 241-5775
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3612
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26486
BLUE SHIELD
ND
05
—
74033
—
ND
Enumeration date
10/12/2006
Last updated
05/09/2014
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