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Individual

TINA MARIE ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1115 ELKTON DR STE 102, COLORADO SPRINGS, CO 80907-3597
(719) 357-6471
(719) 434-9811
Mailing address
3400 WOODCOCK ST APT O4, BERTHOUD, CO 80513-7030
(970) 689-6843

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
7190
OH
103T00000X
Psychologist
Primary
PSY.0004324
CO

Other

Enumeration date
08/11/2014
Last updated
10/11/2021
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