Provider Demographics
NPI:1770862831
Name:ROHRBERG, ANNE-MARIE JENSEN (BS, IBCLC)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:JENSEN
Last Name:ROHRBERG
Suffix:
Gender:F
Credentials:BS, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RUSSET LN
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-2117
Mailing Address - Country:US
Mailing Address - Phone:978-760-0438
Mailing Address - Fax:
Practice Address - Street 1:30 RUSSET LN
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:MA
Practice Address - Zip Code:01775-2117
Practice Address - Country:US
Practice Address - Phone:978-760-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106-22964174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN