Individual
HEIDI DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 W MARKET ST, WARREN, OH 44481-1017
(330) 392-1134
Mailing address
103 W MARKET ST, WARREN, OH 44481-1017
(330) 392-1134
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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