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Individual

MRS. ROBERTA L. BLOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.CCC/SLP

Contact information

Practice address
10133 N GETTYSBURG CT, MEQUON, WI 53092-5456
(262) 242-0099
Mailing address
10133 N GETTYSBURG CT, MEQUON, WI 53092-5456
(262) 242-0099

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
541-154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42673800
WI
Enumeration date
04/28/2008
Last updated
04/28/2008
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