MARY JO ROSEBERRY PH.D. NPI 1225081599

NPI Information

Mary Jo Roseberry, PH.D. is a health service psychologist in Muncie, IN. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). Mary Jo Roseberry, PH.D. NPI is 1225081599. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

240 N TILLOTSON AVE
MUNCIE, IN
ZIP 47304-988
Phone: (765) 288-1928
Fax: (765) 741-0340

The enumeration date for this NPI number is 5/18/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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