Individual
DERRELL COLBY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
382 THAYER ST, PROVIDENCE, RI 02906-1558
(401) 648-7172
(401) 648-0161
Mailing address
382 THAYER ST, PROVIDENCE, RI 02906-1558
(401) 648-7172
(401) 648-0161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02914
RI
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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