Provider Demographics
NPI:1700856887
Name:ROZZELLE, VANESSA K (MA, MED)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:K
Last Name:ROZZELLE
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 STANTON ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-3124
Mailing Address - Country:US
Mailing Address - Phone:732-340-9393
Mailing Address - Fax:732-340-9519
Practice Address - Street 1:1441 IRVING ST
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-4032
Practice Address - Country:US
Practice Address - Phone:732-340-9393
Practice Address - Fax:732-340-9519
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00284700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional