Individual
CHRYSTA LOUISE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
479 RUSSELL ST STE 102, ASHLAND, OR 97520-7331
(541) 708-1403
Mailing address
479 RUSSELL ST STE 102, ASHLAND, OR 97520-7331
(541) 708-1403
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60152242
WA
106H00000X
Marriage & Family Therapist
Primary
T0825
OR
Other
Enumeration date
02/07/2008
Last updated
05/12/2015
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