Individual
CHARLES BRAD ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4710 W SAGINAW HWY STE 1, LANSING, MI 48917-2654
(517) 684-0577
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
(517) 676-3438
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011149
MI
Other
Enumeration date
11/17/2015
Last updated
04/27/2020
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