Individual
MARLA J LAROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6600
Mailing address
2246 N 65TH ST, WAUWATOSA, WI 53213-2034
(414) 774-8516
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7258-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43592500
—
WI
Enumeration date
07/13/2006
Last updated
01/11/2023
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