Provider Demographics
NPI:1275079543
Name:LUEHRS, ROSE E (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:E
Last Name:LUEHRS
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 S WILDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4765
Mailing Address - Country:US
Mailing Address - Phone:920-377-3770
Mailing Address - Fax:
Practice Address - Street 1:1108 S WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4765
Practice Address - Country:US
Practice Address - Phone:920-377-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC 3005101YM0800X
390200000X
WI5095-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program