Individual
HEIDI A LAROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12830 W PEACHTREE DR, NEW BERLIN, WI 53151-7623
(414) 858-9706
Mailing address
12830 WEST PEACHTREE DR, NEW BERLIN, WI 53151
(414) 858-9706
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
5565-024
WI
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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