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Individual

MRS. GRACE E BRANHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1035 N MAIN ST, RICE LAKE, WI 54868-1260
(715) 234-4313
Mailing address
1035 N MAIN ST, RICE LAKE, WI 54868-1260
(715) 234-7477

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
183-124
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39793200
WI
Enumeration date
12/19/2006
Last updated
07/09/2007
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