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General NPI Number Information
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NPI Number | 1083875033
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Entity Type | Individual
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Provider Name | ROSEMARIE EDSON LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 765 ATTUCKS LN
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City | HYANNIS
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State | MA
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Zip | 02601-1867
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Country | US
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Telephone | 508-957-0200
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Fax | 508-957-0299
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Provider Business Mailing Address
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Address Line | PO BOX 609 19 QUANSET ROAD
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City | SOUTH ORLEANS
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State | MA
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Zip | 02662
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Country | US
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Telephone | 508-957-0200
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Fax | 508-957-0299
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 107479
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License Number State | MA
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