Individual
ELYSSIA DE LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 GEORGE ST FL 1, LOWELL, MA 01852-2228
(978) 453-5736
Mailing address
45 MILTON ST, LAWRENCE, MA 01841-4550
(978) 872-0238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
06/12/2026
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