Individual
ROSE FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1169 EASTERN PKWY, SUITE 3364, LOUISVILLE, KY 40217-1417
(502) 742-2336
(502) 813-8281
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
165258
KY
Other
Enumeration date
10/16/2012
Last updated
06/03/2016
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