| Doctor Name: | ROBERT A. ROSE |
| NPI Number: | 1033226360 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 0344 |
| Business Practice Address: | Va Medical Center 2400 Hospital Road Tuskegee, AL - 360835001 |
| Business Phone Number: | 3347270550 |
| Business Fax Number: | 3347253262 |
| Mailing Address: | 722 Patrick Rd, AUBURN |
| State: | AL |
| Postal Code: | 368307572 |
| Phone Number: | 3348879048 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |