Healthcare Provider Details

I. General information

NPI: 1467386516
Provider Name (Legal Business Name): AMY G ROHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S1450 CTY RD CC
SPRING VALLEY WI
54011
US

IV. Provider business mailing address

W5475 570TH AVE
ELLSWORTH WI
54011-5121
US

V. Phone/Fax

Practice location:
  • Phone: 715-821-5902
  • Fax:
Mailing address:
  • Phone: 715-821-5902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1590067920
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: