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Organization

RESILIENT JOURNEY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD ROTH PSYD, APNP (OWNER)
(847) 340-5785
Entity
Organization

Contact information

Practice address
13500 WATERTOWN PLANK RD STE 102, ELM GROVE, WI 53122-2222
(847) 340-5785
Mailing address
2630 9TH AVE, SOUTH MILWAUKEE, WI 53172-3216
(847) 340-5785

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
03/07/2023
Last updated
06/22/2023
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