Individual
ANNA GRACE HOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
600 W VIRGINIA ST, SUITE 203, MILWAUKEE, WI 53204-1500
(414) 831-4500
Mailing address
827 N 17TH ST, APT. 304, MILWAUKEE, WI 53233-3302
(920) 450-0960
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16045-130
WI
Other
Enumeration date
05/20/2011
Last updated
08/29/2011
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