Individual
DR. GERALD MATTHEW ROHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1784 BARTON AVE, SUITE NUMBER 16, WEST BEND, WI 53090-5474
(262) 334-1322
(262) 334-1325
Mailing address
611 NORTH ST, WEST BEND, WI 53090-2515
(262) 306-7189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2435057
WI
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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