MEDICARE: RHONDA KARLTON ROSEN LSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW-000517E	PA

General Provider Information

NPI Number	:	1114923141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA KARLTON ROSEN LSW, LCSW

Provider Business Mailing Address
First Line	:	470 CONRAD DR
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-4010
Country	:	US
Telephone Number	:	412-487-1967
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 CONRAD DR
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-4010
Country	:	US
Telephone Number	:	412-487-1967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/14/2016

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