Provider Demographics
NPI:1073398699
Name:MOHRMANN, ROSA
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:MOHRMANN
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 1:63 WHEELOCK RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:VT
Mailing Address - Zip Code:05825-7605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 WHEELOCK RD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:VT
Practice Address - Zip Code:05825-7605
Practice Address - Country:US
Practice Address - Phone:802-673-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician