Rose Psychological Services, Llc | |
240 Creekstone Rdg Woodstock GA 30188-3732 | |
(404) 532-9246 | |
Not Available |
Full Name | Rose Psychological Services, Llc |
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Speciality | Psychologist |
Location | 240 Creekstone Rdg, Woodstock, Georgia |
Authorized Official Name and Position | Sara Roland Rose (OWNER) |
Authorized Official Contact | 4045329246 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rose Psychological Services, Llc 240 Creekstone Rdg Woodstock GA 30188-3732 Ph: (404) 532-9246 | Rose Psychological Services, Llc 240 Creekstone Rdg Woodstock GA 30188-3732 Ph: (404) 532-9246 |
NPI Number | 1144767591 |
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Provider Enumeration Date | 01/24/2017 |
Last Update Date | 01/24/2017 |
Medicare PECOS PAC ID | 0446534176 |
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Medicare Enrollment ID | O20170224001402 |
Identifier | Type | State | Issuer |
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1144767591 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | PSY004066 (Georgia) | Primary |
Provider Name | Sara Roland Rose |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1639543218 PECOS PAC ID: 1355625088 Enrollment ID: I20170224001454 |
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