Provider Demographics
NPI:1871999011
Name:VERTY, ROSELENE J
Entity type:Individual
Prefix:MRS
First Name:ROSELENE
Middle Name:J
Last Name:VERTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSELENE
Other - Middle Name:J
Other - Last Name:VERTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4548 OAK TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3700
Mailing Address - Country:US
Mailing Address - Phone:561-301-0662
Mailing Address - Fax:
Practice Address - Street 1:1639 FORUM PLACE SUITE #7
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-712-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health