Provider Demographics
NPI:1689814659
Name:WELLER, ROZA MARIA (MED MFT)
Entity Type:Individual
Prefix:MS
First Name:ROZA
Middle Name:MARIA
Last Name:WELLER
Suffix:
Gender:F
Credentials:MED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 S ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7116
Mailing Address - Country:US
Mailing Address - Phone:775-856-6200
Mailing Address - Fax:775-856-6208
Practice Address - Street 1:1090 S ROCK BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7116
Practice Address - Country:US
Practice Address - Phone:775-856-6200
Practice Address - Fax:775-856-6208
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist