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Individual

MS. LORI LYNN ROST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
1626 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 338-8611
(262) 338-3367
Mailing address
1626 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 338-8611
(262) 338-3367

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2101-132
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39393800
WI
Enumeration date
04/08/2008
Last updated
04/08/2008
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