Organization
CARYL H. ROSEN, PH.D. AND ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARYL H ROSEN PH.D. (PRESIDENT)
(219) 201-0711
Entity
Organization
Contact information
Practice address
9250 COLUMBIA AVE STE 2F, MUNSTER, IN 46321-3530
(219) 201-0711
(219) 836-6445
Mailing address
9250 COLUMBIA AVE STE 2F, MUNSTER, IN 46321-3530
(219) 201-0711
(219) 836-6445
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90000882
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
03/15/2010
Last updated
08/01/2019
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