Individual provider · Type 1 NPI

Mary Rose, MA LPC CACII

Addiction (Substance Use Disorder) Counselor · Longmont, CO

NPI number 1912316993 Active

Practice location

709 3rd Ave
Longmont, CO 80501-5926

Mailing address

PO Box 1301
Longmont, CO 80502-1301

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X11721 (CO)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1912316993

Mary Rose, MA LPC CACII's National Provider Identifier is 1912316993, issued on Aug 4, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Longmont, CO. The record was last updated on Aug 4, 2014.