Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003224379 |
---|---|
Provider Name | Jennifer Rosas |
First Address | Sitka, AK 99835-7666 |
Second Address | Sitka, AK 99835-7666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2014 |
Last Update Date | 30/07/2014 |