Provider Demographics
NPI:1689849085
Name:JUAREZ, ROSANNE C
Entity Type:Individual
Prefix:
First Name:ROSANNE
Middle Name:C
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 SAWDUST RD STE 1101
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2580
Mailing Address - Country:US
Mailing Address - Phone:832-766-0995
Mailing Address - Fax:832-604-3914
Practice Address - Street 1:2219 SAWDUST RD STE 1101
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2580
Practice Address - Country:US
Practice Address - Phone:832-766-0995
Practice Address - Fax:832-604-3914
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional