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1962109538
DERRELL COLBY ROSE
PROVIDENCE, RI
NPI
1962109538
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: RI CSW02914)
Enumeration Date
2023-02-14
Last Update Date
2023-02-14
Business Address
DERRELL COLBY ROSE
382 THAYER ST
PROVIDENCE, RI 02906-1558
Phone number: 401-648-7172
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Mailing Address
DERRELL COLBY ROSE
382 THAYER ST
PROVIDENCE, RI 02906-1558
Phone number: 401-648-7172
Copy
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