Individual
SHIRA DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1522 E PERKINS AVE STE A, SANDUSKY, OH 44870-7991
(419) 610-2308
Mailing address
1522 E PERKINS AVE STE A, SANDUSKY, OH 44870-7991
(419) 610-2308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
OH
Other
Enumeration date
12/08/2010
Last updated
01/24/2023
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