Provider Demographics
NPI:1225470180
Name:OSEGUERA, ROSEMARY (LMSW)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:OSEGUERA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:OSEGUERA WITHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:6038 E VIENNA RD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-9136
Mailing Address - Country:US
Mailing Address - Phone:810-214-2854
Mailing Address - Fax:810-631-4185
Practice Address - Street 1:11831 MAPLE RD STE 5
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-8487
Practice Address - Country:US
Practice Address - Phone:810-214-2854
Practice Address - Fax:810-631-4185
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-20
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010816961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical