Provider Demographics
NPI:1033348941
Name:MROCH, AMELIA ROSE (MS)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:ROSE
Last Name:MROCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:ROSE
Other - Last Name:WOLTANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC 845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6218
Mailing Address - Fax:616-486-6110
Practice Address - Street 1:145 MICHIGAN ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2562
Practice Address - Country:US
Practice Address - Phone:616-486-6218
Practice Address - Fax:616-486-6110
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS