Individual
MS. RENNAY A ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1601 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 243-6660
(305) 243-4595
Mailing address
1120 NW 14TH ST STE 1210, MIAMI, FL 33136-2107
(305) 243-6660
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000512700
—
FL
05
—
767185700
—
FL
Enumeration date
02/08/2007
Last updated
04/15/2014
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