Individual
JAMIE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C, NCC
Contact information
Practice address
280B GANNETT DR, SOUTH PORTLAND, ME 04106-6940
(207) 828-0048
Mailing address
112 SUMMIT TER APT 70, SOUTH PORTLAND, ME 04106-2272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL4831
ME
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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