Individual
DEREK ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
15 CLEVELAND AVE STE 11, MARTINSVILLE, VA 24112-2926
(276) 634-8304
(276) 258-6476
Mailing address
15 CLEVELAND AVE STE 11, MARTINSVILLE, VA 24112-2926
(276) 634-8304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012026
VA
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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