Provider Demographics
NPI:1700041258
Name:ROSEN THERAPY LLC
Entity Type:Organization
Organization Name:ROSEN THERAPY LLC
Other - Org Name:KIDS SPEAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC/SLP
Authorized Official - Phone:972-814-9116
Mailing Address - Street 1:12722 CONCHO DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0979
Mailing Address - Country:US
Mailing Address - Phone:972-814-9116
Mailing Address - Fax:972-731-0607
Practice Address - Street 1:12722 CONCHO DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0979
Practice Address - Country:US
Practice Address - Phone:972-814-9116
Practice Address - Fax:972-731-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181121801Medicaid
TX528515OtherBLUE CROSS AND BLUE SHIELD