Provider Demographics
NPI:1558525212
Name:ROSENBERG, JESSICA E (MA BA MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MA BA MSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:SEBLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:235 NORTH STEVENS STREET
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501
Mailing Address - Country:US
Mailing Address - Phone:715-362-4546
Mailing Address - Fax:715-845-8483
Practice Address - Street 1:310 SOUTH SUPERIOR STREET
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409
Practice Address - Country:US
Practice Address - Phone:715-842-5577
Practice Address - Fax:715-845-8483
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31551231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical