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Individual

MRS. ELIZABETH JANE GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S

Contact information

Practice address
1971 WASHINGTON ST, SUITE 200, GRAFTON, WI 53024-2122
(262) 377-6276
(262) 377-6289
Mailing address
408 W FLORIDA ST, APT 716, MILWAUKEE, WI 53204-1509
(847) 530-0406

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18021-130
WI
101YP2500X
Professional Counselor
Primary
3218-226
WI

Other

Enumeration date
01/12/2017
Last updated
01/12/2017
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