Individual
LAURA ANN GRONHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1150 N ROOSEVELT DR APT 104, SEASIDE, OR 97138-7053
(503) 717-7161
(503) 717-7159
Mailing address
1150 N ROOSEVELT DR APT 104, SEASIDE, OR 97138-7053
(503) 717-7161
(503) 717-7159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5726
OR
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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