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General NPI Number Information
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NPI Number | 1184961682
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Entity Type | Individual
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Provider Name | KARIANNE SZPAK ROSE
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Gender | Female
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 11840 BROOKSIDE DR
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City | BRADENTON
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State | FL
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Zip | 34211-4527
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Country | US
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Telephone | 724-777-1518
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Fax |
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Provider Business Mailing Address
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Address Line | 11840 BROOKSIDE DR
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34211-4527
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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