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General NPI Number Information
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NPI Number | 1497264105
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Entity Type | Individual
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Provider Name | ROCHELLE CROMWELL
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Gender | Female
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 5109 WORLD DAIRY DR
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City | MADISON
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State | WI
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Zip | 53718-3807
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Country | US
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Telephone | 608-467-5826
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 WOODVIEW CT APT 2
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City | MADISON
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State | WI
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Zip | 53713-1990
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Country | US
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Telephone |
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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