Provider Demographics
NPI:1043064553
Name:ROSEMORE, SYDNEY HOPE
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:HOPE
Last Name:ROSEMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 SPRING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-6604
Mailing Address - Country:US
Mailing Address - Phone:678-488-1559
Mailing Address - Fax:
Practice Address - Street 1:6355 SPRING LAKE DR
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-6604
Practice Address - Country:US
Practice Address - Phone:678-488-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002873101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional