Provider Demographics
NPI:1295167518
Name:MULSER, ROSA MARIA (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSA MARIA
Middle Name:
Last Name:MULSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 WOODRUFF PARK SALON SUITES, SUIT 1
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401
Mailing Address - Country:US
Mailing Address - Phone:504-495-4434
Mailing Address - Fax:
Practice Address - Street 1:1710 WOODRUFF PARK SALON SUITES, SUITE 1
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401
Practice Address - Country:US
Practice Address - Phone:208-888-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1447426465Medicaid
ID1370128OtherMEDICARE GROUP
ID1447426465Medicare PIN
ID1370128Medicare UPIN
ID1447426465Medicare Oscar/Certification
ID1370128Medicare Oscar/Certification
ID1447426465Medicaid
ID1447426465Medicare NSC
ID1370128OtherMEDICARE GROUP