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Individual

JEWELIA HARGROVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2800 E ENTERPRISE AVE STE 333, APPLETON, WI 54913-7889
(262) 358-8064
Mailing address
5611 52ND ST APT 10, KENOSHA, WI 53144-2273
(262) 358-8064

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
5090-226
WI
101YP2500X
Professional Counselor
Primary
10273-125
WI

Other

Enumeration date
09/22/2021
Last updated
07/03/2023
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