Individual
MS. DONNA RUTH GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10045 W LISBON AVE, WAUWATOSA, WI 53222-2446
(414) 358-7999
(414) 358-7158
Mailing address
10045 W LISBON AVE, WAUWATOSA, WI 53222-2446
(414) 358-7999
(414) 358-7158
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
561-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
561-226
STATE LICENSE
WI
Enumeration date
02/23/2012
Last updated
02/23/2012
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