Individual
JACODY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7240 CROWDER BLVD, SUITE 202, NEW ORLEANS, LA 70127-1922
(504) 644-4132
Mailing address
7240 CROWDER BLVD, SUITE 202, NEW ORLEANS, LA 70127-1922
(504) 644-4132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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