Provider Demographics
NPI:1518376037
Name:ROSENGARTEN, DINA LYNNE (LMSW)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:LYNNE
Last Name:ROSENGARTEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3625
Mailing Address - Country:US
Mailing Address - Phone:520-770-1197
Mailing Address - Fax:520-207-3855
Practice Address - Street 1:1200 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3625
Practice Address - Country:US
Practice Address - Phone:520-770-1197
Practice Address - Fax:520-207-3855
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW13930104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker