| Doctor Name: | JUDITH ROBERTS |
| NPI Number: | 1558687699 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, RN |
| License Number: | 13198930 |
| Business Practice Address: | 719 W Main St Wautoma, WI - 549828503 |
| Business Phone Number: | 9207877472 |
| Business Fax Number: | 9207875458 |
| Mailing Address: | 719 W Main St, WAUTOMA |
| State: | WI |
| Postal Code: | 549828503 |
| Phone Number: | 9207877472 |
| Fax Number: | 9207875458 |
| NPI Enumeration Date: | 04/14/2010 |
| NPI Last Update Date: | 04/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 13198930 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |