Individual
JEREMY ROSENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1004 S GLENVIEW DR, CARBONDALE, IL 62901-2441
(618) 534-5936
Mailing address
1004 S GLENVIEW DR, CARBONDALE, IL 62901-2441
(618) 534-5936
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.011097
IL
Other
Enumeration date
11/17/2015
Last updated
12/17/2024
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