Provider Demographics
NPI:1619571817
Name:LOVE, ROSALYN M (QMHS)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:M
Last Name:LOVE
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 NAVARRE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3178
Mailing Address - Country:US
Mailing Address - Phone:156-725-5709
Mailing Address - Fax:
Practice Address - Street 1:2300 NAVARRE AVE STE 200
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3178
Practice Address - Country:US
Practice Address - Phone:419-764-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty