Provider Demographics
NPI:1821398868
Name:ROSILLO, ANGELA (LMHC,)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ROSILLO
Suffix:
Gender:F
Credentials:LMHC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 AVENUE AU SOLEIL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6122
Mailing Address - Country:US
Mailing Address - Phone:561-274-4224
Mailing Address - Fax:
Practice Address - Street 1:2665 AVENUE AU SOLEIL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6122
Practice Address - Country:US
Practice Address - Phone:561-274-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health