Provider Demographics
NPI:1467886044
Name:ROHRER, KELLEY L (AUD)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:L
Last Name:ROHRER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:L
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5420 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-9481
Mailing Address - Country:US
Mailing Address - Phone:802-336-8020
Mailing Address - Fax:
Practice Address - Street 1:5420 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9481
Practice Address - Country:US
Practice Address - Phone:802-366-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT145.0114343231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist