Organization
DEROSE FAMILY COUNSELING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALIA DEROSE PHD (CERTIFIED PSYCHOTHERAPIST)
(262) 633-1235
Entity
Organization
Contact information
Practice address
316 5TH ST, SUITE 1, RACINE, WI 53403-4606
(262) 633-1235
(262) 633-1236
Mailing address
316 5TH ST, SUITE 1, RACINE, WI 53403-4606
(262) 633-1235
(262) 633-1236
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2958
WI
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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