Individual
JOSEPH F ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
136 W BROADWAY AVE, MEDFORD, WI 54451-1757
(715) 748-4535
(715) 748-0627
Mailing address
PO BOX 297, MEDFORD, WI 54451-0297
(715) 748-4535
(715) 748-0627
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1375-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39231800
—
WI
Enumeration date
02/25/2008
Last updated
02/25/2008
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