Provider Demographics
NPI:1134684996
Name:ROWLAND, RODNEY HAROLD SR (APSW)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:HAROLD
Last Name:ROWLAND
Suffix:SR
Gender:M
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153212 GRANITE HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6386
Mailing Address - Country:US
Mailing Address - Phone:715-409-1014
Mailing Address - Fax:
Practice Address - Street 1:153212 GRANITE HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-6386
Practice Address - Country:US
Practice Address - Phone:715-409-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1185-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1185-121Other1185-121