Organization
ROSAEN PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ROSAEN PSYD (PRESIDENT)
(734) 306-5143
Entity
Organization
Contact information
Practice address
550 FOREST AVE STE 16-3, PLYMOUTH, MI 48170-3793
(734) 306-5143
Mailing address
98 NB GRATIOT AVE UNIT 31, MOUNT CLEMENS, MI 48043-2371
(734) 306-5143
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6301016069
MI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6301016069
MI
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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