Provider Demographics
NPI:1285941583
Name:ROSE, CLAIRE BARBARA
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:BARBARA
Last Name:ROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CLAIRE
Other - Middle Name:B
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMT
Mailing Address - Street 1:219 PLYMOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1222
Mailing Address - Country:US
Mailing Address - Phone:508-963-1734
Mailing Address - Fax:508-947-2794
Practice Address - Street 1:219 PLYMOUTH ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1222
Practice Address - Country:US
Practice Address - Phone:508-963-1734
Practice Address - Fax:508-947-2794
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0125225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist