Branham, Grace E

Branham, Grace E is an individual health care provider with primary practice located at 1035 N Main St , Rice Lake WI 54868-1260. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Branham, Grace E can be contacted via phone (715) 234-4313.

Contact Information

Primary practice address
1035 N Main St Rice Lake WI 54868-1260
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 183-124 Wisconsin

Profile Details

NPI number 1154484962
LBN Legal business name Branham, Grace E
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154484962 NPPES
Wisconsin MEDICAID 39793200

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