Provider Demographics
NPI:1255834164
Name:CANTU, ROSITA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSITA
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9263 ENCINO VLG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4937
Mailing Address - Country:US
Mailing Address - Phone:210-563-1043
Mailing Address - Fax:
Practice Address - Street 1:9263 ENCINO VLG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4937
Practice Address - Country:US
Practice Address - Phone:210-563-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX412521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical