Individual
JARETT EDWARD ROSEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD., LP
Contact information
Practice address
11850 BLACKFOOT ST NW STE 400, COON RAPIDS, MN 55433-2776
(763) 236-8911
Mailing address
11850 BLACKFOOT ST NW STE 405, COON RAPIDS, MN 55433-2773
(763) 236-0888
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3438-57
WI
103T00000X
Psychologist
Primary
LP6148
MN
Other
Enumeration date
08/10/2017
Last updated
03/11/2021
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