Individual
JACQUELINE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
172 S PANTOPS DR STE B, CHARLOTTESVILLE, VA 22911-8672
(804) 596-5313
Mailing address
172 S PANTOPS DR STE B, CHARLOTTESVILLE, VA 22911-8672
(804) 596-5313
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904015994
VA
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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