Individual
ROSITA M FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
318 MARGARET CT, BURLINGTON, WI 53105-2330
(812) 201-3912
Mailing address
318 MARGARET CT, BURLINGTON, WI 53105-2330
(812) 201-3912
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3535
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376062851
—
WI
05
—
300007198IN
—
IN
Enumeration date
09/15/2017
Last updated
01/08/2022
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