Provider Demographics
NPI:1093586240
Name:DELAROSA, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DELAROSA
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 1:14228 POETS ROCK LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2716
Mailing Address - Country:US
Mailing Address - Phone:915-276-0376
Mailing Address - Fax:
Practice Address - Street 1:14228 POETS ROCK LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2716
Practice Address - Country:US
Practice Address - Phone:915-276-0376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty