Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 362 | SC |
NPI | 1013071802 |
---|---|
Provider Name | Dr. Janet Rose |
First Address | Charleston, SC 29401-2633 |
Second Address | Charleston, SC 29401-2633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |