| Doctor Name: | SANDRA A ROELLICH |
| NPI Number: | 1033126198 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | CERT #1344 |
| Business Practice Address: | 238 Front Street Scenic Bluffs Health Center Cashton, WI - 54619 |
| Business Phone Number: | 6086545100 |
| Business Fax Number: | 6086545120 |
| Mailing Address: | Po Box 39, 238 Front Street - Scenic Bluffs Health Center CASHTON |
| State: | WI |
| Postal Code: | 54619 |
| Phone Number: | 6086545100 |
| Fax Number: | 6086545120 |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 12/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CERT #1344 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |