Provider Demographics
NPI:1710796685
Name:ROSE, EMILLEE MARY
Entity type:Individual
Prefix:
First Name:EMILLEE
Middle Name:MARY
Last Name:ROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FRANK LN
Mailing Address - Street 2:
Mailing Address - City:FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:18615-7823
Mailing Address - Country:US
Mailing Address - Phone:570-209-0595
Mailing Address - Fax:
Practice Address - Street 1:11 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-6421
Practice Address - Country:US
Practice Address - Phone:484-941-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health