Provider Demographics
NPI:1518449024
Name:BROSIUS, ROEL KAY (MSW)
Entity Type:Individual
Prefix:MS
First Name:ROEL
Middle Name:KAY
Last Name:BROSIUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8059 TWAIN HARTE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-0125
Mailing Address - Country:US
Mailing Address - Phone:702-533-1664
Mailing Address - Fax:
Practice Address - Street 1:8059 TWAIN HARTE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-0125
Practice Address - Country:US
Practice Address - Phone:702-533-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8038-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker