Individual
MICHAEL DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3805B SPRING ST, SUITE 320, MOUNT PLEASANT, WI 53405-1641
(262) 687-2222
(262) 687-8611
Mailing address
3805B SPRING ST STE 320, MOUNT PLEASANT, WI 53405-1644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8319
WI
Other
Enumeration date
08/20/2015
Last updated
02/11/2019
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