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Individual
MRS. NETTIE LYNNE ROSE
Active
Individual
MRS. NETTIE LYNNE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW LADAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4198
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-4453
NM
101YM0800X
Mental Health Counselor
I4453
NM
Other
Enumeration date
10/31/2005
Last updated
09/09/2020
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