Provider Demographics
NPI:1598199119
Name:ROHLOFF, AMANDA KAY (LADC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAY
Last Name:ROHLOFF
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1510 BEMIDJI AVENUE NORTH SUITE 13
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601
Mailing Address - Country:US
Mailing Address - Phone:218-444-5740
Mailing Address - Fax:218-333-0241
Practice Address - Street 1:403 4TH ST NW STE 300
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3196
Practice Address - Country:US
Practice Address - Phone:218-444-5155
Practice Address - Fax:218-333-3921
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI303394101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)