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Individual

DR. MARY W ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D, C.B.S.M

Contact information

Practice address
400 N TEXAS AVENUE, SUITE B, WEBSTER, TX 77598
(281) 316-8400
(281) 318-8410
Mailing address
400 N. TEXAS AVENUE, SUITE B, WEBSTER, TX 77598
(281) 316-8400
(281) 318-8410

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
31557
TX
173F00000X
Sleep Specialist (PhD)
Primary
3-1557
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
147062701
TX
Enumeration date
10/02/2006
Last updated
08/01/2013
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