MEDICARE: TONI A ROHE LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CC3109	ME

General Provider Information

NPI Number	:	1932395266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI A ROHE LCPC

Provider Business Mailing Address
First Line	:	18 HIGH ST
Second Line	:	P O BOX 723
City	:	HOULTON
State	:	ME
Zip	:	04730-2013
Country	:	US
Telephone Number	:	207-532-9660
Fax Number	:	207-532-9640

Provider Business Practice Location Address
First Line	:	147 ACADEMY ST
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-3101
Country	:	US
Telephone Number	:	207-764-6258
Fax Number	:	207-764-6077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	09/20/2007

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