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Individual

DR. AARON JOHN GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
210 NW BARSTOW ST, SUITE 201, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 548-3820
Mailing address
210 NW BARSTOW ST, SUITE 201, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 548-3820

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3049-57
WI
103TH0004X
Health Psychologist
Primary
3049-57
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720311467
WI
Enumeration date
09/14/2009
Last updated
10/29/2012
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