Individual
LAURA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2209 EASTERN AVE, PLYMOUTH, WI 53073-4281
(920) 892-7606
Mailing address
1627 N 10TH ST, SHEBOYGAN, WI 53081-2619
(920) 207-0651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1675-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083008684
—
WI
Enumeration date
03/23/2015
Last updated
07/01/2022
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