Healthcare Provider Details

I. General information

NPI: 1215445754
Provider Name (Legal Business Name): JENNIFER ROHLFS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 N ACADEMY BLVD STE 101
COLORADO SPRINGS CO
80918-4055
US

IV. Provider business mailing address

PO BOX 76510
COLORADO SPRINGS CO
80970-6510
US

V. Phone/Fax

Practice location:
  • Phone: 940-368-7105
  • Fax: 719-316-6746
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-32255
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: