Doctor Name: | DR. JENNIFER RENE ROSSI |
NPI Number: | 1841236544 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1602 |
Business Practice Address: | 5 Saint Johns Way Reedsport, OR - 974671794 |
Business Phone Number: | 5416620527 |
Business Fax Number: | 5412719502 |
Mailing Address: | Po Box 734, REEDSPORT |
State: | OR |
Postal Code: | 974670734 |
Phone Number: | 5416620527 |
Fax Number: | 5412719502 |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 11/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |