Individual
SHANNON ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW CSWA
Contact information
Practice address
8385 DIVISION RD, WHITE CITY, OR 97503-1176
(541) 826-5853
(541) 826-5843
Mailing address
900 E MAIN ST STE 201, MEDFORD, OR 97504-7136
(541) 842-7705
(541) 842-7640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6498
OR
Other
Enumeration date
04/18/2012
Last updated
02/14/2019
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