Provider Demographics
NPI:1376138891
Name:HOSEMANN, ROBIN MARIE (LPC-IT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIE
Last Name:HOSEMANN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-1359
Mailing Address - Country:US
Mailing Address - Phone:608-606-6244
Mailing Address - Fax:
Practice Address - Street 1:414 S EAST AVE
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-2006
Practice Address - Country:US
Practice Address - Phone:608-638-3332
Practice Address - Fax:608-637-7328
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4906226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health