Individual
BLAKE JAMES GRONOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, LPC/A
Contact information
Practice address
141 MCDONALD CT, MYRTLE BEACH, SC 29588-6134
(843) 294-0646
Mailing address
3930 SAINT IVES RD UNIT 516, MYRTLE BEACH, SC 29588-1164
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8231
SC
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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