Provider Demographics
NPI:1508554734
Name:ROSE-WARDLAW, DARLENE A (MA/CAGS)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:A
Last Name:ROSE-WARDLAW
Suffix:
Gender:F
Credentials:MA/CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3234
Mailing Address - Country:US
Mailing Address - Phone:413-387-1102
Mailing Address - Fax:413-582-5656
Practice Address - Street 1:131 KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3234
Practice Address - Country:US
Practice Address - Phone:413-387-1102
Practice Address - Fax:413-582-5656
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency