Individual
LAURIE ANN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
310 S BARTLETT ST, SHAWANO, WI 54166-2704
(715) 526-3666
(715) 526-3666
Mailing address
310 S BARTLETT ST, SHAWANO, WI 54166-2704
(715) 526-3666
(715) 526-3666
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801083650
MI
1041C0700X
Clinical Social Worker
Primary
7483-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008970100
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
01/11/2006
Last updated
04/05/2010
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