Individual
MS. GRACE LOUISE JESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
207 E BUFFALO ST, SUITE 510, MILWAUKEE, WI 53202-5739
(262) 375-7022
Mailing address
W62N248 WASHINGTON AVE, SUITE 207, CEDARBURG, WI 53012-2768
(262) 375-1116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3469-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40917300
—
WI
Enumeration date
08/25/2006
Last updated
04/29/2009
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