Individual
DR. ROSALYN ROESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, PH.D.
Contact information
Practice address
1983 DELEGAL DR NE, TOWNSEND, GA 31331-7425
(912) 667-5079
(912) 832-4693
Mailing address
1983 DELEGAL DR NE, TOWNSEND, GA 31331-7425
(912) 667-5079
(912) 832-4693
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY001032
GA
103T00000X
Psychologist
Primary
PSY001032
GA
103TC0700X
Clinical Psychologist
PSY001032
GA
103TF0000X
Family Psychologist
PSY001032
GA
103TF0200X
Forensic Psychologist
PSY001032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000366627A
—
GA
Enumeration date
08/20/2006
Last updated
10/09/2009
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