Individual
KELLY E GROSKLAGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
621 W LAKE ST, SUITE 209, MINNEAPOLIS, MN 55408-2949
(612) 825-7400
Mailing address
621 W LAKE ST, SUITE 209, MINNEAPOLIS, MN 55408-2949
(612) 825-7400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW 9927
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3076650
HEALTH PARTNERS
MN
01
—
318M3GR
BCBS
MN
01
—
6290368
MEDICA
MN
Enumeration date
05/21/2007
Last updated
07/08/2007
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