Provider Demographics
NPI:1114393907
Name:ROSEN, DEBORAH CAPUTO (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CAPUTO
Last Name:ROSEN
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 1:1116 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1936
Mailing Address - Country:US
Mailing Address - Phone:610-420-7612
Mailing Address - Fax:
Practice Address - Street 1:1116 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1936
Practice Address - Country:US
Practice Address - Phone:610-420-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007231L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist