Provider Demographics
NPI:1831939065
Name:ROSE, PAAVO ABRAHAM
Entity type:Individual
Prefix:
First Name:PAAVO
Middle Name:ABRAHAM
Last Name:ROSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LAYNE
Other - Middle Name:ALLAN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-4612
Mailing Address - Country:US
Mailing Address - Phone:313-498-8357
Mailing Address - Fax:
Practice Address - Street 1:70 MICHIGAN AVE W STE 212
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3619
Practice Address - Country:US
Practice Address - Phone:313-498-8357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst