Provider Demographics
NPI:1063180305
Name:ROHRER, KRISTEN ANN (MED, EDS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:ROHRER
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANN
Other - Last Name:ROHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, EDS
Mailing Address - Street 1:6743 BALE KENYON RD
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9437
Mailing Address - Country:US
Mailing Address - Phone:740-657-7523
Mailing Address - Fax:
Practice Address - Street 1:6743 BALE KENYON RD
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9437
Practice Address - Country:US
Practice Address - Phone:740-657-7523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool