Individual
AVA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1824 MADISON AVE, NEW YORK, NY 10035-3832
(212) 423-4200
(646) 770-8401
Mailing address
78 ELMORE AVE, ENGLEWOOD, NJ 07631-3318
(201) 927-4060
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
076548
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076548
LICENSE FOR MASTER OF SOCIAL WORK
NY
Enumeration date
10/16/2017
Last updated
10/16/2017
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