Doctor Name: | MISS SUSAN ROLF |
NPI Number: | 1174661326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA QMHP |
License Number: | |
Business Practice Address: | 121 E 2nd St Beardstown, IL - 626181263 |
Business Phone Number: | 2173232980 |
Business Fax Number: | 2173233731 |
Mailing Address: | 121 E 2nd St, BEARDSTOWN |
State: | IL |
Postal Code: | 626181263 |
Phone Number: | 2173232980 |
Fax Number: | 2173233731 |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |