Provider Demographics
NPI:1548804503
Name:ROSARIO, JENNIFER E (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:ROSARIO
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 1:1600 AVE PONCE DE LEON
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1844
Mailing Address - Country:US
Mailing Address - Phone:787-469-2023
Mailing Address - Fax:
Practice Address - Street 1:1600 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1844
Practice Address - Country:US
Practice Address - Phone:787-469-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
10844OtherMSW