Provider Demographics
NPI:1114267408
Name:ROSENWASSER, BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:ROSENWASSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 PUTNAM RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1022
Mailing Address - Country:US
Mailing Address - Phone:610-660-0262
Mailing Address - Fax:
Practice Address - Street 1:553 PUTNAM RD
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1022
Practice Address - Country:US
Practice Address - Phone:610-660-0262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002059101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional