Provider Demographics
NPI:1255868816
Name:ROSARIO, GERMINUDY R
Entity Type:Individual
Prefix:MRS
First Name:GERMINUDY
Middle Name:R
Last Name:ROSARIO
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 1:9 MEMORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2005
Mailing Address - Country:US
Mailing Address - Phone:978-701-4944
Mailing Address - Fax:
Practice Address - Street 1:9 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-2005
Practice Address - Country:US
Practice Address - Phone:978-701-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor