Individual
KELLY ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
495 QUAIL RUN RD, SUMMIT POINT, WV 25446-3609
(703) 209-4476
Mailing address
495 QUAIL RUN RD, SUMMIT POINT, WV 25446-3609
(703) 209-4476
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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