Individual
MS. SARA L DE GRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LPC, CSAC
Contact information
Practice address
17100 W NORTH AVE STE 100, BROOKFIELD, WI 53005-4450
(262) 786-9184
(262) 786-1906
Mailing address
2343 N 116TH ST, WAUWATOSA, WI 53226-1109
(414) 614-3751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15661-132
WI
101YM0800X
Mental Health Counselor
Primary
4275-125
WI
101YP2500X
Professional Counselor
4275-125
WI
Other
Enumeration date
03/05/2008
Last updated
05/13/2021
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