Provider Demographics
NPI:1679966253
Name:COELHO, ROSIE (LAC)
Entity Type:Individual
Prefix:
First Name:ROSIE
Middle Name:
Last Name:COELHO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 HEMPHILL PARK
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2812
Mailing Address - Country:US
Mailing Address - Phone:512-775-7504
Mailing Address - Fax:855-207-7868
Practice Address - Street 1:3102 HEMPHILL PARK
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2812
Practice Address - Country:US
Practice Address - Phone:512-775-7504
Practice Address - Fax:855-207-7868
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01539171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist