Individual
MS. JACQUELINE E ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
789 GILMORE AVE, NORTH TONAWANDA, NY 14120-6743
(716) 807-3753
(716) 870-3751
Mailing address
789 GILMORE AVE, NORTH TONAWANDA, NY 14120
(716) 807-3753
(716) 870-3751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
088228
NY
1041S0200X
School Social Worker
Primary
39487
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01377162
—
NY
Enumeration date
10/14/2011
Last updated
08/14/2024
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