Provider Demographics
NPI:1285318147
Name:ROHDE, GENEVIEVE VIOLET LOUISE
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:VIOLET LOUISE
Last Name:ROHDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14387 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8460
Mailing Address - Country:US
Mailing Address - Phone:218-831-7801
Mailing Address - Fax:
Practice Address - Street 1:808 N 10TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2645
Practice Address - Country:US
Practice Address - Phone:218-831-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst