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Organization

INNERCHANGE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS B ROBERTS LCSW (PRESIDENT)
(608) 783-2186
Entity
Organization

Contact information

Practice address
1401 MAIN ST, ONALASKA, WI 54650-2858
(608) 783-2186
(608) 781-3405
Mailing address
1401 MAIN ST, ONALASKA, WI 54650-2858
(608) 783-2186
(608) 781-3405

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1435
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42165700
WI
Enumeration date
01/12/2007
Last updated
03/05/2009
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