| Derose Family Counseling, Llc. | |
|
316 5th St Suite 1 Racine WI 53403-4606 | |
| (262) 633-1235 | |
| (262) 633-1236 |
| Full Name | Derose Family Counseling, Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 316 5th St, Racine, Wisconsin |
| Authorized Official Name and Position | Talia Derose (CERTIFIED PSYCHOTHERAPIST) |
| Authorized Official Contact | 2626331235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Derose Family Counseling, Llc. 316 5th St Suite 1 Racine WI 53403-4606 Ph: (262) 633-1235 | Derose Family Counseling, Llc. 316 5th St Suite 1 Racine WI 53403-4606 Ph: (262) 633-1235 |
| NPI Number | 1437423563 |
|---|---|
| Provider Enumeration Date | 03/07/2012 |
| Last Update Date | 03/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437423563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2958 (Wisconsin) | Primary |
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