Doctor Name: | MS. REBECCA SNYDER ROSE |
NPI Number: | 1457482721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2084 |
Business Practice Address: | 527 W 3rd St Konawa, OK - 748491415 |
Business Phone Number: | 5809253286 |
Business Fax Number: | 5809252362 |
Mailing Address: | 527 W 3rd St, KONAWA |
State: | OK |
Postal Code: | 748491415 |
Phone Number: | 5809253286 |
Fax Number: | 5809252362 |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 02/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2084 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |