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General NPI Number Information
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NPI Number | 1609878453
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Entity Type | Individual
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Provider Name | CHERYL JOY ROETS PHD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 705 S UNIVERSITY AVE STE 200
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City | BEAVER DAM
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State | WI
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Zip | 53916-3079
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Country | US
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Telephone | 920-887-9272
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Fax | 920-885-4752
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1776
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License Number State | WI
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