Provider Demographics
NPI:1649417445
Name:GUZMAN-ROSA, WENDY JANETTE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JANETTE
Last Name:GUZMAN-ROSA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JANETTE
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:73 LORRAINE TER APT 321
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1237
Mailing Address - Country:US
Mailing Address - Phone:914-772-2290
Mailing Address - Fax:
Practice Address - Street 1:73 LORRAINE TER APT 321
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1237
Practice Address - Country:US
Practice Address - Phone:914-772-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker