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Organization

CHRISTIAN COMMUNITY RESOURCES, LLC

Active
Other names
Freedom Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL LACE PSYD (PSYCHOLOGIST)
(715) 838-8898
Entity
Organization

Contact information

Practice address
2141 ALTOONA AVE, SUITE C, EAU CLAIRE, WI 54701-3429
(715) 552-7350
Mailing address
PO BOX 1426, EAU CLAIRE, WI 54702-1426
(715) 552-7350

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33333
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39365600
WI
Enumeration date
07/23/2007
Last updated
07/23/2007
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