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Individual

SANDRA A ROELLICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
238 FRONT STREET, SCENIC BLUFFS HEALTH CENTER, CASHTON, WI 54619
(608) 654-5100
(608) 654-5120
Mailing address
PO BOX 39, 238 FRONT STREET - SCENIC BLUFFS HEALTH CENTER, CASHTON, WI 54619
(608) 654-5100
(608) 654-5120

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CERT #1344
WI
1041C0700X
Clinical Social Worker
1378
WI
1041C0700X
Clinical Social Worker
Primary
1378-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39290700
WI
Enumeration date
08/02/2006
Last updated
12/06/2010
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