Individual
DANIELLE GRAHAM - HEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1213-226
WI
Other
Enumeration date
04/07/2014
Last updated
04/07/2014
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