Individual
MRS. TONYA ANNE GROTHE-BUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1024 7TH AVE, WORTHINGTON, MN 56187-2287
(507) 376-4141
Mailing address
205 3RD ST NW, PO BOX 92, FULDA, MN 56131-1108
(507) 380-8806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
00122
MN
106H00000X
Marriage & Family Therapist
Primary
1410
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
931613000
—
MN
Enumeration date
05/25/2007
Last updated
05/09/2008
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