Provider Demographics
NPI:1356891543
Name:ROSENFIELD, CAROL
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ROSENFIELD
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 1:17351 E MANSFIELD AVE
Mailing Address - Street 2:431 L
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-8202
Mailing Address - Country:US
Mailing Address - Phone:720-205-0855
Mailing Address - Fax:
Practice Address - Street 1:17351 E MANSFIELD AVE
Practice Address - Street 2:431 L
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-8202
Practice Address - Country:US
Practice Address - Phone:720-205-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16-18857106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician