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General NPI Number Information
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NPI Number | 1952809436
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Entity Type | Organization
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Legal Business Name | DALE K. ROSE, LMFT, INC., CSAT
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 12725 VENTURA BLVD STE K
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City | STUDIO CITY
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State | CA
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Zip | 91604-2437
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Country | US
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Telephone | 818-783-1283
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Fax | 818-783-7673
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Provider Business Mailing Address
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Address Line | 12725 VENTURA BLVD STE K
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City | STUDIO CITY
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State | CA
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Zip | 91604-2437
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Country | US
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Telephone | 818-783-1283
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Fax | 818-783-7673
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DALE K. ROSE
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Credential | LMFT
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Telephone | 818-783-1283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC36408
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License Number State | CA
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