Provider Demographics
NPI:1962641407
Name:ZARKIN, ROSELLA ANN (MSW,ICSW,BCD)
Entity Type:Individual
Prefix:
First Name:ROSELLA
Middle Name:ANN
Last Name:ZARKIN
Suffix:
Gender:F
Credentials:MSW,ICSW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 WATERMAN ST
Mailing Address - Street 2:4
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3919
Mailing Address - Country:US
Mailing Address - Phone:401-331-3420
Mailing Address - Fax:
Practice Address - Street 1:173 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3919
Practice Address - Country:US
Practice Address - Phone:401-331-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW001541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical