Individual
NICOLE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6240 WOODHAVEN BLVD, REGO PARK, NY 11374-3733
(718) 426-8110
(718) 426-8117
Mailing address
16517 144TH TER, JAMAICA, NY 11434-5124
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
443401
NY
106H00000X
Marriage & Family Therapist
Primary
000659-1
NY
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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