Most Relevant Information
Provider Data
| NPI Number: | 1003577446 |
| Provider Name: | HEATHER GROVUM |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | CC03075 |
Most Important Dates
| Enumeration Date: | 01/07/2022 |
| Last Updated: | 01/07/2022 |
Provider Practice Location
310 W 48TH ST
MINNEAPOLIS
MN
554195418
Practice Location Phone/Fax
| Phone: | 7017404783 |
| Fax: |
Provider Mailing Location
310 W 48TH ST
MINNEAPOLIS
MN
554195418
Provider Mailing Phone/Fax
| Phone: | 7017404783 |
| Fax: |