| Doctor Name: | LASHUNDA ROSE |
| NPI Number: | 1184953176 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN/THERAPIST |
| License Number: | |
| Business Practice Address: | 1825 E Broadway St Forrest City, AR - 723353409 |
| Business Phone Number: | 8706302328 |
| Business Fax Number: | 8706302348 |
| Mailing Address: | 210 Manor St, MARION |
| State: | AR |
| Postal Code: | 723641936 |
| Phone Number: | 8707396818 |
| Fax Number: | 8707396821 |
| NPI Enumeration Date: | 12/22/2009 |
| NPI Last Update Date: | 12/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |