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Warren Goggleye, CD
Mental Health Counselor in Grand Rapids, Minnesota
NPI 1467779553

Warren Goggleye is a Mental Health Counselor based in Grand Rapids, MN and is specialized in Mental Health. Warren Goggleye practices in Grand Rapids, MN and has the professional credentials of CD. The NPI Number for Warren Goggleye is 1467779553 and holds a License No. 302475 (Minnesota).

The current practice location address for Warren Goggleye is 604 S Pokegama Ave, Grand Rapids, MN and can be reached out via phone at 218-327-9944.

Location: 604 S Pokegama Ave, Grand Rapids, MN, 55744-3831
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467779553
Provider Name
Warren Goggleye
Credential
CD
Provider Entity Type
Individual
Gender
Male
Address
604 S Pokegama Ave, Grand Rapids, MN, 55744-3831
Phone Number
218-327-9944
Fax Number
Provider Enumeration Date
04/28/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
302475 01 MN STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
604 S Pokegama Ave
City
Grand Rapids
State
Minnesota
Zip
55744-3831
Phone Number
218-327-9944
Fax Number
person
Provider Business Mailing Address Details
Address
604 S Pokegama Ave
City
Grand Rapids
State
Minnesota
Zip
55744-3831
Phone Number
218-327-9944
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
302475 (Minnesota)
Definition
Definition to come...
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