Individual
RAFAEL ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1712 ISLETA BLVD SW APT 3A, ALBUQUERQUE, NM 87105-4752
(505) 918-7959
Mailing address
1712 ISLETA BLVD SW APT 3A, ALBUQUERQUE, NM 87105-4752
(505) 918-7959
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3768720716
—
NM
Enumeration date
04/25/2018
Last updated
04/25/2018
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