Provider Demographics
NPI:1831480011
Name:COHLMIA, ROSE MARIE
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:MARIE
Last Name:COHLMIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 S GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5509
Mailing Address - Country:US
Mailing Address - Phone:580-278-9134
Mailing Address - Fax:
Practice Address - Street 1:418 S GARFIELD ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5509
Practice Address - Country:US
Practice Address - Phone:580-278-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst