Individual
MRS. ANDREA LINETTE GROSSKURTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6809 122ND AVE, KENOSHA, WI 53142-7335
(262) 652-5522
(262) 652-7228
Mailing address
6809 122ND AVE, KENOSHA, WI 53142-7335
(262) 652-5522
(262) 652-7228
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8609
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497016752
—
WI
Enumeration date
06/04/2012
Last updated
11/23/2020
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