Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003238601 |
---|---|
Provider Name | Mrs. Ashleigh Rosinbaum |
First Address | Benton, AR 72015-2929 |
Second Address | Benton, AR 72015-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2014 |
Last Update Date | 16/01/2014 |