| Doctor Name: | DR. ANN R ROTHLISBERGER |
| NPI Number: | 1205983145 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICENSED CLINICAL PR |
| License Number: | 91974956004 |
| Business Practice Address: | 447 N 300 W Suite 7 Kaysville, UT - 840374203 |
| Business Phone Number: | 4108528459 |
| Business Fax Number: | 8015446558 |
| Mailing Address: | 447 N 300 W, Suite 7 KAYSVILLE |
| State: | UT |
| Postal Code: | 840374203 |
| Phone Number: | 4108528459 |
| Fax Number: | 8015446558 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 91974956004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |