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General NPI Number Information
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NPI Number | 1649378258
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Entity Type | Individual
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Provider Name | BETH NANCY ROSEN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 334 THOMAS MORE PKWY
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-301-5901
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Fax | 859-301-5940
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Provider Business Mailing Address
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Address Line | PO BOX 635283
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City | CINCINNATI
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State | OH
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Zip | 45263-5283
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Country | US
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Telephone | 859-301-5901
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Fax | 859-301-5940
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS00608
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6311
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 175058
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License Number State | KY
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