Provider Demographics
NPI:1114358546
Name:ORR, ROSA OYOLA (LLPC)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:OYOLA
Last Name:ORR
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 S HURON PKWY APT 1
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5145
Mailing Address - Country:US
Mailing Address - Phone:734-747-2903
Mailing Address - Fax:
Practice Address - Street 1:5675 LARKINS ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-1934
Practice Address - Country:US
Practice Address - Phone:313-515-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional