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Individual

DEBRA JEAN ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
55700 M 43, BANGOR, MI 49013-9566
(269) 427-8909
Mailing address
55700 M 43, BANGOR, MI 49013-9566
(269) 427-8909

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
AF800016057
MI

Other

Enumeration date
09/15/2021
Last updated
09/15/2021
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