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General NPI Number Information
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NPI Number | 1154075240
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Entity Type | Individual
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Provider Name | DANETTE ROSE
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Gender | Female
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 21580 LOOP 494
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City | NEW CANEY
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State | TX
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Zip | 77357-8239
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Country | US
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Telephone | 281-577-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 3307 OLD IRONWOOD DR
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City | SPRING
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State | TX
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Zip | 77386-1042
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Country | US
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Telephone | 309-791-2807
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 109715
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License Number State | TX
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