Provider Demographics
NPI:1356184337
Name:ROSENDO, ANDREA LAUREEN
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LAUREEN
Last Name:ROSENDO
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 1:19 LINCOLN AVE E
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2619
Mailing Address - Country:US
Mailing Address - Phone:914-512-1473
Mailing Address - Fax:
Practice Address - Street 1:19 LINCOLN AVE E
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2619
Practice Address - Country:US
Practice Address - Phone:914-512-1473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool