Individual
MS. ALEXIS ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22661 GRAY FOX DR, CANYON LAKE, CA 92587-7584
(909) 732-2575
Mailing address
22661 GRAY FOX DR, CANYON LAKE, CA 92587-7584
(909) 732-2575
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
72406
CA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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