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1912316993
MARY ROSE
LONGMONT, CO
NPI
1912316993
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO 11721)
Enumeration Date
2014-08-04
Last Update Date
2014-08-04
Business Address
-- MARY ROSE MA LPC CACII
709 3RD AVE
LONGMONT, CO 80501-5926
Phone number: 720-340-2710
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Mailing Address
-- MARY ROSE MA LPC CACII
PO BOX 1301
LONGMONT, CO 80502-1301
Phone number: 720-340-2710
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