Individual
MRS. CARRIE LYNN ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 THIRD AVE STE C3, CHULA VISTA, CA 91911-3139
(619) 691-8164
Mailing address
1180 THIRD AVE STE C3, CHULA VISTA, CA 91911-3139
(619) 691-8164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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