Individual
MRS. AMY GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
630 S 36TH AVE, WAUSAU, WI 54401-3930
(715) 842-9500
Mailing address
630 S 36TH AVE, WAUSAU, WI 54401-3930
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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