Individual
DR. CIEMONE SAMATURA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP, NCC
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043067A
IN
Other
Enumeration date
12/17/2020
Last updated
02/01/2021
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