Organization
C VAN ROSEN PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. C VAN ROSEN PHD (PRESIDENT)
(251) 621-2990
Entity
Organization
Contact information
Practice address
28980 HWY 98, SUITE 1, DAPHNE, AL 36526-7283
(251) 621-2990
(251) 621-2921
Mailing address
28980 HWY 98, SUITE 1, DAPHNE, AL 36526-7283
(251) 621-2990
(251) 621-2921
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000070686
—
AL
01
—
51506934
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
04/25/2008
Last updated
04/25/2008
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