MEDICARE: ROCHELLE ROSE

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	101YM0800X	Mental Health Counselor	0734006525	VA

General Provider Information

NPI Number	:	1235870593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE ROSE

Provider Business Mailing Address
First Line	:	11300 IRON BRIDGE RD
Second Line	:	D
City	:	CHESTER
State	:	VA
Zip	:	23831-1428
Country	:	US
Telephone Number	:	215-218-8900
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 IRON BRIDGE RD
Second Line	:	D
City	:	CHESTER
State	:	VA
Zip	:	23831-1428
Country	:	US
Telephone Number	:	215-218-8900
Fax Number	:

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

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	04/01/2022

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Directions to “ ROCHELLE ROSE ” Practice Location

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