Provider Demographics
NPI:1811984826
Name:ROWLISON, MICHELLE (LICENSED MARRIAGE)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:ROWLISON
Suffix:
Gender:F
Credentials:LICENSED MARRIAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CONCORD EXCHANGE N
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-1104
Mailing Address - Country:US
Mailing Address - Phone:651-451-2889
Mailing Address - Fax:651-451-5955
Practice Address - Street 1:201 CONCORD EXCHANGE N
Practice Address - Street 2:
Practice Address - City:SOUTH SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1104
Practice Address - Country:US
Practice Address - Phone:651-451-2889
Practice Address - Fax:651-451-5955
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist