MR. Jon Mitchel Rose, LCSW

NPI #1669655494 in Pine Bush, New York

Provider Information

NPI Number: 1669655494
Entity Type: Individual
Name: MR. Jon Mitchel Rose, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Dec 16, 2007
Last Updated: Dec 16, 2007

Practice Location

Address: 89 BONIFACE DR
City: Pine Bush
State: New York
ZIP Code: 12566-7011
Phone: (845) 744-6974

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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