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Individual
DEREK ROSE
Active
Individual
DEREK ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012026
VA
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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