Individual
MISS GRADY EMILY DEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, SAC-IT, CCAT
Contact information
Practice address
304 BICKFORD ST, NEW LISBON, WI 53950-1533
(608) 562-3976
(608) 562-3975
Mailing address
304 BICKFORD ST, NEW LISBON, WI 53950-1533
(608) 562-3976
(608) 562-3975
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8436-125
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/04/2019
Last updated
09/14/2022
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