Burdick-Grade, Megan J.

Burdick-Grade, Megan J. is an individual health care provider with primary practice located at 1478 Kenwood Ctr Suite 1, Menasha WI 54952-1161. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Burdick-Grade, Megan J. can be contacted via phone (920) 886-9319.

Contact Information

Primary practice address
1478 Kenwood Ctr Suite 1 Menasha WI 54952-1161
Fax: (920) 886-9357
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 595-124 Wisconsin

Profile Details

NPI number 1235149642
LBN Legal business name Burdick-Grade, Megan J.
Credentials M.A., LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Sep 17th, 2008 - about 16 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 1235149642 NPPES
Wisconsin MEDICAID 39798700

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