Most Relevant Information
Provider Data
| NPI Number: | 1003548652 |
| Provider Name: | CATHERINE ROSE LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | R032298-01 |
Most Important Dates
| Enumeration Date: | 06/30/2022 |
| Last Updated: | 06/30/2022 |
Provider Practice Location
1211 BUCKNELL DRIVE
MASSAPEQUA
NY
11758
Practice Location Phone/Fax
| Phone: | 9172824877 |
| Fax: |
Provider Mailing Location
1211 BUCKNELL DRIVE
MASSAPEQUA
NY
11758
Provider Mailing Phone/Fax
| Phone: | 9172824877 |
| Fax: |