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Individual
ROSE R JETER
Active
Individual
ROSE R JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
083428
NY
1041C0700X
Clinical Social Worker
Primary
0904009125
VA
Other
Enumeration date
03/11/2016
Last updated
05/28/2016
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