Provider Demographics
NPI:1134889942
Name:ROHRER, ALTHEA T
Entity type:Individual
Prefix:
First Name:ALTHEA
Middle Name:T
Last Name:ROHRER
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 1:2532 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4709
Mailing Address - Country:US
Mailing Address - Phone:641-840-1787
Mailing Address - Fax:
Practice Address - Street 1:2532 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4709
Practice Address - Country:US
Practice Address - Phone:641-840-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLBSW-19511101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor