Roseann I Connerley, LMFT

Individual provider Active NPI Professional Counselor · Redlands, CA

NPI 1972633113 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1972633113
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
MFC36098 (CA)
Practice address
245 Terracina Blvd Ste 206
Redlands, CA 92373-4867
Phone
(909) 307-9824
Fax
(909) 335-9634
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFC36098CAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MFC36098 CA Yes

Addresses

Primary practice location

245 Terracina Blvd Ste 206
Redlands, CA 92373-4867

Mailing address

245 Terracina Blvd Ste 206
Redlands, CA 92373-4867
Phone (909) 307-9824

Other providers in Redlands, CA

All providers in Redlands, CA · Professional Counselor in California

Sources for this page

Verify at the official NPI Registry.