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Individual

MRS. MARSHA G ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW LCSW

Contact information

Practice address
2001 STONEBROOK PLACE, KINGSPORT, TN 37660
(423) 224-1000
(423) 224-1023
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW4305
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
183856
ANTHEM PROF TRIGON
01
2224731
FIRST HEALTH
01
334969
VALUE OPTIONS GROUP
01
3920247
GRP MEDICARE TN
01
3927531
MEDICARE TN
01
4095639
MAGELLAN SUMMIT
Enumeration date
09/11/2006
Last updated
07/08/2007
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