Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS017255 | PA |
Y | 103TC0700X | Clinical Psychologist | PS017255 | PA |
NPI | 1003166422 |
---|---|
Provider Name | Dr. Valerie Rosen |
First Address | Philadelphia, PA 19103-6231 |
Second Address | Ardmore, PA 19003-1920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 23/10/2021 |