Provider Demographics
NPI:1861508343
Name:GRAJKOWSKI, CYNTHIA A (MS ED LMFT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:GRAJKOWSKI
Suffix:
Gender:F
Credentials:MS ED LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 VINE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-5863
Mailing Address - Country:US
Mailing Address - Phone:715-441-1828
Mailing Address - Fax:888-802-9673
Practice Address - Street 1:2217 VINE ST
Practice Address - Street 2:SUITE 206
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-5863
Practice Address - Country:US
Practice Address - Phone:715-441-1828
Practice Address - Fax:888-802-9673
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI693124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist