Individual
GRACIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 STAGELINE RD, HUDSON, WI 54016-7848
(715) 531-6700
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
8447
WI
101YP2500X
Professional Counselor
Primary
8447
WI
Other
Enumeration date
02/21/2022
Last updated
05/12/2025
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