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General NPI Number Information
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NPI Number | 1457362204
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Entity Type | Individual
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Provider Name | TAMIE ROBERTS LPC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 602 PLEASANT OAK DR
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City | OREGON
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State | WI
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Zip | 53575-3282
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Country | US
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Telephone | 608-835-5050
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Fax | 608-835-5010
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Provider Business Mailing Address
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Address Line | 602 PLEASANT OAK DR
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City | OREGON
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State | WI
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Zip | 53575-3282
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Country | US
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Telephone | 608-835-5050
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Fax | 608-835-5010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3047125
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License Number State | WI
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