Individual
DR. CARYL H. ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CARYL H.ROSEN, PH.D.
Contact information
Practice address
9250 COLUMBIA AVE STE 2F, MUNSTER, IN 46321
(219) 201-0711
(219) 836-6445
Mailing address
9250 COLUMBIA AVE STE 2F, MUNSTER, IN 46321-3530
(219) 201-0711
(219) 836-6445
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071005821
IL
103TC0700X
Clinical Psychologist
Primary
20041300A
IN
103TC0700X
Clinical Psychologist
PY9548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634892
BLUE CROSS BLUE SHIELD
IL
01
—
90000882
BLUE CROSS BLUE SHIELD OF ILLINOIS
IN
Enumeration date
11/06/2006
Last updated
08/01/2019
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