Le Grand, Christine T

Le Grand, Christine T is an individual health care provider with primary practice located at 6789 N Green Bay Rd , Glendale WI 53209-3472. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Le Grand, Christine T can be contacted via phone (414) 828-1856.

Contact Information

Primary practice address
6789 N Green Bay Rd Glendale WI 53209-3472
Phone: (414) 828-1856
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 59-136 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 3878-125 Wisconsin

Profile Details

NPI number 1619010790
LBN Legal business name Le Grand, Christine T
Credentials LPC, ATRL-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Sep 18th, 2009 - 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 1619010790 NPPES
Wisconsin MEDICAID 40948900

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