Provider Demographics
NPI:1730528142
Name:ROLFES, ELIZABETH JOETTE (MS, LADC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOETTE
Last Name:ROLFES
Suffix:
Gender:F
Credentials:MS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 HUDSON RD STE 600
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1469
Mailing Address - Country:US
Mailing Address - Phone:651-731-0031
Mailing Address - Fax:
Practice Address - Street 1:7700 HUDSON RD STE 600
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1469
Practice Address - Country:US
Practice Address - Phone:651-731-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302453101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)