Provider Demographics
NPI:1922267228
Name:HARE, ROSALYNN DENISE (MS)
Entity Type:Individual
Prefix:MS
First Name:ROSALYNN
Middle Name:DENISE
Last Name:HARE
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 1:2830 MORNING LAKE DR
Mailing Address - Street 2:APT #102
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8497
Mailing Address - Country:US
Mailing Address - Phone:901-252-7886
Mailing Address - Fax:901-252-7990
Practice Address - Street 1:7426 MEMPHIS ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-1908
Practice Address - Country:US
Practice Address - Phone:901-252-7980
Practice Address - Fax:901-252-7990
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health