| Doctor Name: | MS. ROSE D. ROBERTS |
| NPI Number: | 1982811535 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACSW,QCSW,DCSW |
| License Number: | C0003 |
| Business Practice Address: | 19 W. Reynolds Street 1088 Pontotoc, MS - 388631088 |
| Business Phone Number: | 6624891102 |
| Business Fax Number: | 6624898966 |
| Mailing Address: | 252 Highway 9 N, P.o. Box 1088 PONTOTOC |
| State: | MS |
| Postal Code: | 388631536 |
| Phone Number: | 6624895570 |
| Fax Number: | 6624898966 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C0003 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |