Provider Demographics
NPI:1275757338
Name:ROSAS NAZARIO, ROSA (MA)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:
Last Name:ROSAS NAZARIO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BA 40 CALLE 64
Mailing Address - Street 2:URB HILL MANSIONS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-409-0663
Mailing Address - Fax:787-740-2559
Practice Address - Street 1:INSTITUTO DE TERAPIA FAMILIAR
Practice Address - Street 2:BAYAMON SHOPPING CENTER SUITE 10E MINI MALL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-798-9097
Practice Address - Fax:787-740-2559
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1867103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist