Grace Healing and Wellness Center, Llc.

NPI #1467190694 in Pewaukee, Wisconsin

Provider Information

NPI Number: 1467190694
Entity Type: Organization
Organization Name: Grace Healing and Wellness Center, Llc.
Primary Specialty: Psychologist - Clinical
Enumeration Date: May 26, 2022
Last Updated: May 26, 2022

Practice Location

Address: N28W23000 ROUNDY DR STE 105
City: Pewaukee
State: Wisconsin
ZIP Code: 53072-7300
Phone: (414) 350-6693

Authorized Official

Name: ANGELIQUE LEWIS, PHD
Title: PSYCHOLOGIST
Phone: (414) 350-6693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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