Individual
LISA GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
2010 LASALLE AVE, SUITE A, WACO, TX 76706
(254) 297-7171
Mailing address
PO BOX 890, WACO, TX 76703-0890
(254) 752-3451
(254) 756-3133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
101YP2500X
Professional Counselor
—
TX
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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