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Individual

DR. MICHAEL BARRY ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
6192 OXON HILL RD, SUITE 403, OXON HILL, MD 20745-3143
(301) 567-7791
(301) 567-7795
Mailing address
6208 SYDNEY RD, SUITE 403, FAIRFAX STATION, VA 22039-1689
(301) 567-7791
(301) 567-7795

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00977
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115011100
MD
Enumeration date
12/28/2006
Last updated
01/20/2016
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