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General NPI Number Information
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NPI Number | 1518096981
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Entity Type | Individual
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Provider Name | IRMA GARCIA ROSE LCSW, MSW, MA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 1012 N 5TH AVE NE
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City | ROME
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State | GA
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Zip | 30165-2602
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Country | US
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Telephone | 706-232-1111
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Fax | 706-387-3435
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Provider Business Mailing Address
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Address Line | 1012 N 5TH AVE NE
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City | ROME
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State | GA
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Zip | 30165-2602
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Country | US
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Telephone | 706-232-1111
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Fax | 706-378-3435
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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 | CSW002837
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0252491
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License Number State | NY
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