Individual
LISA J BILDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
516 S POKEGAMA AVE, GRAND RAPIDS, MN 55744-3800
(218) 327-2001
Mailing address
12299 S ELLIS AVE UNIT 106, TRAVERSE CITY, MI 49684-2712
(218) 327-2001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2561
MN
101YP2500X
Professional Counselor
Primary
2561
MN
Other
Enumeration date
08/11/2020
Last updated
03/13/2025
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