Individual
DR. MICHAEL RICHARD ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, PH.D.
Contact information
Practice address
4915 W BELL RD, SUITE 202, GLENDALE, AZ 85308-3425
(602) 316-3529
(623) 444-7643
Mailing address
6604 W TONTO DR, GLENDALE, AZ 85308-7026
(602) 316-3529
(623) 444-7643
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCSW-3693
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-3693
AZ
Other
Enumeration date
05/16/2006
Last updated
01/30/2008
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