Provider Demographics
NPI:1881217701
Name:PATTON, ROSEMARIE ANGELA
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:ANGELA
Last Name:PATTON
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 1:23294 MCQUEENEY AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-5946
Mailing Address - Country:US
Mailing Address - Phone:941-882-0114
Mailing Address - Fax:
Practice Address - Street 1:23294 MCQUEENEY AVE
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-5946
Practice Address - Country:US
Practice Address - Phone:941-882-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker