Individual
ROSEMARY M UNTERSEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 440-3673
(541) 440-3508
Mailing address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 440-3673
(541) 440-3508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4054
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138395
MEDICARE PTAN
—
05
—
50019850
—
OR
Enumeration date
07/27/2007
Last updated
08/30/2012
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