Provider Demographics
NPI:1396403770
Name:LE, ROSA OSIRIS
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:OSIRIS
Last Name:LE
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 1:1885 MANNING WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4860
Mailing Address - Country:US
Mailing Address - Phone:719-287-3340
Mailing Address - Fax:
Practice Address - Street 1:1885 MANNING WAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-4860
Practice Address - Country:US
Practice Address - Phone:719-287-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor