Individual
LISA ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11-12-65
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L5470
OR
Other
Enumeration date
08/03/2010
Last updated
09/25/2012
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