Doctor Name: | KATHLEEN ROSE |
NPI Number: | 1043492572 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 111867 |
Business Practice Address: | 555 Amory St Suite 5 Jamaica Plain, MA - 021302652 |
Business Phone Number: | 6173836522 |
Business Fax Number: | 6173836520 |
Mailing Address: | 555 Amory St, Suite 5 JAMAICA PLAIN |
State: | MA |
Postal Code: | 021302652 |
Phone Number: | 6173836522 |
Fax Number: | 6173836520 |
NPI Enumeration Date: | 11/27/2007 |
NPI Last Update Date: | 11/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 111867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |