Rose, Jennifer Beth

Rose, Jennifer Beth is an sole proprietor health care provider with primary practice located at 2111 Golf Course Rd Se Ste D , Rio Rancho NM 87124-1634. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Rose, Jennifer Beth can be contacted via phone (505) 639-1312.

Contact Information

Primary practice address
2111 Golf Course Rd Se Ste D Rio Rancho NM 87124-1634
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C-06999 New Mexico

Profile Details

NPI number 1104864255
LBN Legal business name Rose, Jennifer Beth
Credentials LISW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2006
Last updated Feb 12th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104864255 NPPES
New Mexico MEDICAID 02351714
New Mexico Other 1598218190
New Mexico Other 1104864255
New Mexico MEDICAID 17301866

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