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1235546110
EMPRESS ANDREA GRAY
MILWAUKEE, WI
NPI
1235546110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 17180-130)
Enumeration Date
2014-07-12
Last Update Date
2014-07-12
Business Address
-- EMPRESS ANDREA GRAY
2048 N 34TH ST
MILWAUKEE, WI 53208-1967
Phone number: 414-400-1526
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Mailing Address
-- EMPRESS ANDREA GRAY
2048 N 34TH ST
MILWAUKEE, WI 53208-1967
Phone number: 414-400-1526
Copy
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