Provider Demographics
NPI:1619108545
Name:ROSE, WHITNEY LEIGH
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEIGH
Last Name:ROSE
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 1:11 LAWRENCE ST.
Mailing Address - Street 2:SUITE 322
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 LAWRENCE ST
Practice Address - Street 2:SUITE 322
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1431
Practice Address - Country:US
Practice Address - Phone:978-620-2514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor