Provider Demographics
NPI:1417097148
Name:ROHEN, TERRENCE MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:MICHAEL
Last Name:ROHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 1ST CAPITOL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2768
Mailing Address - Country:US
Mailing Address - Phone:636-946-1500
Mailing Address - Fax:636-946-1516
Practice Address - Street 1:501 1ST CAPITOL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2768
Practice Address - Country:US
Practice Address - Phone:636-946-1500
Practice Address - Fax:636-946-1516
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00672103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical