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General NPI Number Information
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NPI Number | 1245956754
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Entity Type | Individual
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Provider Name | SAHCAREION MATERIC ROLLINS MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 12751 COUNTY ROAD 5 STE 193
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City | BURNSVILLE
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State | MN
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Zip | 55337-2283
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Country | US
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Telephone | 952-210-3592
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Fax |
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Provider Business Mailing Address
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Address Line | 12685 GERMANE AVE APT 2
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City | APPLE VALLEY
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State | MN
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Zip | 55124-4375
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Country | US
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Telephone | 952-210-3592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3526
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License Number State | MN
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