Provider Demographics
NPI:1912248022
Name:ROSE-GROSS, ROBBIN VIRGINIA
Entity Type:Individual
Prefix:MRS
First Name:ROBBIN
Middle Name:VIRGINIA
Last Name:ROSE-GROSS
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 1:4500 FORBES BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6316
Mailing Address - Country:US
Mailing Address - Phone:240-650-0211
Mailing Address - Fax:240-266-5606
Practice Address - Street 1:4500 FORBES BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6316
Practice Address - Country:US
Practice Address - Phone:240-650-0211
Practice Address - Fax:240-266-5606
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2974101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional