Provider Demographics
NPI:1891072369
Name:EMRICH, ROSEMARY A (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:A
Last Name:EMRICH
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:A
Other - Last Name:BANACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8839
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87504-8839
Mailing Address - Country:US
Mailing Address - Phone:505-983-8225
Mailing Address - Fax:
Practice Address - Street 1:2019 GALISTEO ST
Practice Address - Street 2:SUITE E-2
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2143
Practice Address - Country:US
Practice Address - Phone:505-983-8225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0173951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health