Individual
HALEY ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13035 W BLUEMOUND RD, BROOKFIELD, WI 53005-8001
(262) 244-0729
Mailing address
1900 NORHARDT DR APT 314, BROOKFIELD, WI 53045-5088
(262) 717-8055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
02/02/2022
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