Individual
ROSA PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3100 PREMIER DR STE 234, IRVING, TX 75063-2693
(972) 756-1222
Mailing address
3100 PREMIER DR STE 234, IRVING, TX 75063-2693
(972) 756-1222
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-15-08909
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-15-08909
BACB
TX
Enumeration date
02/10/2019
Last updated
02/10/2019
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