MEDICARE: MS. MARLENE O'ROSCO

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	2348	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2348	OTHER	VA	STATE DBHD LICENSE

General Provider Information

NPI Number	:	1891118030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARLENE O'ROSCO

Provider Business Mailing Address
First Line	:	1600 E LITTLE CREEK RD
Second Line	:	SUITE 315
City	:	NORFOLK
State	:	VA
Zip	:	23518-4136
Country	:	US
Telephone Number	:	757-962-8640
Fax Number	:	757-962-8641

Provider Business Practice Location Address
First Line	:	1600 E LITTLE CREEK RD
Second Line	:	SUITE 315
City	:	NORFOLK
State	:	VA
Zip	:	23518-4136
Country	:	US
Telephone Number	:	757-962-8640
Fax Number	:	757-962-8641

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

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	01/23/2014

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