Provider Information for 1912564352
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Mr. DAVID ALLEN ROSSER LCMHC
Sex: Male
NPI: 1912564352
Last Updated: 2024-04-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||
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| NPI | 1912564352 | ||||||||||||||
| Enumeration Date | 2019-05-21 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | PO BOX 818 MOCKSVILLE, NC 27028-0818 United States Phone: 336-940-8690 | Fax: | ||||||||||||||
| Primary Practice Address | 1365 MAIN STREET SUITE 102 MOCKSVILLE, NC 27028 United States Phone: 336-753-6422 | Fax: | ||||||||||||||
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