Provider Demographics
NPI:1144395385
Name:SCHULTE, ROSE M (MS)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:M
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 MCARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5511
Mailing Address - Country:US
Mailing Address - Phone:618-462-0634
Mailing Address - Fax:618-462-3209
Practice Address - Street 1:3512 MCARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5511
Practice Address - Country:US
Practice Address - Phone:618-462-0634
Practice Address - Fax:618-462-3209
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional