Individual
MICHELLE L ROSE-BARAJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
510-126
WI
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
2969-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43590100
—
WI
Enumeration date
07/14/2006
Last updated
11/12/2012
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