Provider Demographics
NPI:1558471110
Name:ROHMAN, TERESA (LMFT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ROHMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:DIANE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1719 ASHLEY CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5823
Mailing Address - Country:US
Mailing Address - Phone:270-904-0200
Mailing Address - Fax:270-904-0206
Practice Address - Street 1:1719 ASHLEY CIR STE 100
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5837
Practice Address - Country:US
Practice Address - Phone:270-904-0200
Practice Address - Fax:270-904-0202
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0540106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30604011Medicaid