Provider Demographics
NPI:1730473620
Name:ELERA, ROSARIO P
Entity Type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:P
Last Name:ELERA
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 1:6001 N BROOKLINE AVE APT 112
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4265
Mailing Address - Country:US
Mailing Address - Phone:405-417-7686
Mailing Address - Fax:405-879-3446
Practice Address - Street 1:6001 N BROOKLINE AVE APT 112
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4265
Practice Address - Country:US
Practice Address - Phone:405-417-7686
Practice Address - Fax:405-879-3446
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst