Individual
SHAKEE'US GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6635
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6635
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19249
WI
1041C0700X
Clinical Social Worker
Primary
133073
WI
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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