Individual
GRANT M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-IT
Contact information
Practice address
1225 PRAIRIE CREEK BLVD UNIT 209, OCONOMOWOC, WI 53066-8685
(608) 302-6395
Mailing address
1225 PRAIRIE CREEK BLVD UNIT 209, OCONOMOWOC, WI 53066-8685
(608) 302-6395
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8671-226
WI
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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