Individual
DR. TARA JEAN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1001 BLYTHE BLVD STE 4200, CHARLOTTE, NC 28203-5866
(704) 355-0101
Mailing address
1001 BLYTHE BLVD STE 4200, CHARLOTTE, NC 28203-5866
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1752
SC
103T00000X
Psychologist
Primary
6935
NC
103TC0700X
Clinical Psychologist
PSY1752
SC
Other
Enumeration date
09/22/2022
Last updated
11/13/2025
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