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Individual

TANNER GRIMSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
2424 32ND AVE S STE 202, GRAND FORKS, ND 58201-6545
(701) 746-6336
(701) 772-1030
Mailing address
2424 32ND AVE S STE 202, GRAND FORKS, ND 58201-6545
(701) 746-6336
(701) 772-1030

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1692
ND
101YP2500X
Professional Counselor
850-10-1-15A
ND

Other

Enumeration date
11/15/2012
Last updated
01/24/2017
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