Provider Demographics
NPI:1033381207
Name:ROHRER, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:ROHRER
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 1:2524 KIRK AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4826
Mailing Address - Country:US
Mailing Address - Phone:410-467-6040
Mailing Address - Fax:410-235-8807
Practice Address - Street 1:2524 KIRK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4826
Practice Address - Country:US
Practice Address - Phone:410-467-6040
Practice Address - Fax:410-235-8807
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA3741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical