Provider Demographics
NPI:1659425031
Name:KOLMAN-STICH, ROSEMARIE ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:ANN
Last Name:KOLMAN-STICH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W
Mailing Address - Street 2:SUITE # N-464
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2801
Mailing Address - Country:US
Mailing Address - Phone:651-659-2931
Mailing Address - Fax:651-645-7307
Practice Address - Street 1:1821 UNIVERSITY AVE W
Practice Address - Street 2:SUITE # N-464
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2801
Practice Address - Country:US
Practice Address - Phone:651-659-2931
Practice Address - Fax:651-645-7307
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical