Individual
FREDERICKA E GRUNHUVD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(603) 883-0005
Mailing address
1220 W SIDE BLVD, BUTTE, MT 59701-2212
(406) 241-2511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
946
MT
1041C0700X
Clinical Social Worker
Primary
LC22546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477745370
—
MT
Enumeration date
05/14/2010
Last updated
04/26/2024
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