Individual provider · Type 1 NPI

Laurieg Lee Grogg Iii

Mental Health Counselor · Lakeport, CA

NPI number 1912045758 Active

Practice location

991 Parallel Dr
Lakeport, CA 95453

Fax (707) 994-7096

Mailing address

3008 Wolf Creek Rd
Clearlake Oaks, CA 95423-9565

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1912045758

Laurieg Lee Grogg Iii's National Provider Identifier is 1912045758, issued on Feb 2, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lakeport, CA. The record was last updated on Jul 8, 2007.