Individual
JUSTIN ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 E 5TH AVE APT 7, SALT LAKE CITY, UT 84103-3650
(913) 481-2538
Mailing address
720 E 5TH AVE APT 7, SALT LAKE CITY, UT 84103-3650
(913) 481-2538
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12835827-3501
UT
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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