Individual
KRISTEN M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5270
(920) 832-5488
Mailing address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5270
(920) 832-5488
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
132457
WI
1041C0700X
Clinical Social Worker
Primary
11395-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188310
—
WI
Enumeration date
12/03/2021
Last updated
09/05/2023
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