Individual
SUSAN A. ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
45 NORTH MAIN STREET, KILMARNOCK, VA 22482
(804) 435-0758
(804) 435-7226
Mailing address
PO BOX 1911, KILMARNOCK, VA 22482-1911
(804) 435-0758
(804) 435-7226
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202000579
VA
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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