Breaking Grit, Llc | |
W10174 29th St Camp Douglas WI 54618-9709 | |
(608) 344-0053 | |
Not Available |
Full Name | Breaking Grit, Llc |
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Speciality | Marriage & Family Therapist |
Location | W10174 29th St, Camp Douglas, Wisconsin |
Authorized Official Name and Position | Keyara Tabbert (JOINT OWNERSHIP) |
Authorized Official Contact | 6083440053 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Breaking Grit, Llc W10174 29th St Camp Douglas WI 54618-9709 Ph: (608) 344-0053 | Breaking Grit, Llc W10174 29th St Camp Douglas WI 54618-9709 Ph: (608) 344-0053 |
NPI Number | 1033921044 |
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Provider Enumeration Date | 01/25/2025 |
Last Update Date | 01/25/2025 |
Certification Date | 01/25/2025 |
Identifier | Type | State | Issuer |
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1033921044 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |