DOUGLAS ROSE

CHEYENNE, WY
NPI1801104070
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  CAP-028)
Enumeration Date2010-09-21
Last Update Date2010-09-21
Business Address
-- DOUGLAS ROSE
507 E 18TH ST
CHEYENNE, WY 82001-4617
Phone number: 307-637-7906
Mailing Address
-- DOUGLAS ROSE
507 E 18TH ST
CHEYENNE, WY 82001-4617
Phone number: 307-637-7906
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