Individual
TIMOTHY GROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3329 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 454-2260
(612) 252-0308
Mailing address
3329 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(651) 454-2260
(612) 252-0308
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303453
MN
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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