Provider Demographics
NPI:1003236514
Name:ROSARIO, JENNIFER ANNE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3466
Mailing Address - Street 2:AMELIA CONTRACT STATION
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-3466
Mailing Address - Country:US
Mailing Address - Phone:787-251-2299
Mailing Address - Fax:
Practice Address - Street 1:PALM COURT, D-3
Practice Address - Street 2:AVE. FLOR DEL VALLE (FINAL), LAS VEGAS
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:939-251-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2023235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist