Provider Demographics
NPI:1215101811
Name:BETH ROSNER, PH.D. LLC
Entity type:Organization
Organization Name:BETH ROSNER, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-804-3436
Mailing Address - Street 1:6176 STORNOWAY DR S
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2168
Mailing Address - Country:US
Mailing Address - Phone:614-804-3436
Mailing Address - Fax:
Practice Address - Street 1:7644 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8159
Practice Address - Country:US
Practice Address - Phone:614-804-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities