Doctor Name: | KATHLEEN E ROBERTS |
NPI Number: | 1184668055 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 1366 |
Business Practice Address: | 700 West Avenue South Attn Physician Services Lacrosse, WI - 54601 |
Business Phone Number: | 6087850940 |
Business Fax Number: | |
Mailing Address: | 700 West Avenue South, Attn Physician Services LACROSSE |
State: | WI |
Postal Code: | 54601 |
Phone Number: | 6087850940 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 04/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |