Individual
MRS. MEGAN J. BURDICK-GRADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
1478 KENWOOD CTR, SUITE 1, MENASHA, WI 54952-1161
(920) 886-9319
(920) 886-9357
Mailing address
3416 S WHIP POOR WILL LN, APPLETON, WI 54915-4563
(920) 993-2290
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
595-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39798700
—
WI
Enumeration date
08/08/2006
Last updated
09/17/2008
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