Individual
LARRI ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, NCC, LPC
Contact information
Practice address
6468 PAULA CT, REX, GA 30273-1636
(770) 639-8434
Mailing address
6468 PAULA CT, REX, GA 30273-1636
(770) 639-8434
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
008419
GA
Other
Enumeration date
12/03/2016
Last updated
12/03/2016
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