Provider Demographics
NPI:1629753330
Name:ROSE, OLIVIA (MA)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 773123
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-3123
Mailing Address - Country:US
Mailing Address - Phone:970-819-9706
Mailing Address - Fax:
Practice Address - Street 1:1169 HILLTOP PKWY UNIT 206A
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-3176
Practice Address - Country:US
Practice Address - Phone:970-761-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health