Individual
ANITA MASTMAN ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8417 WASHINGTON PL NE, ALBUQUERQUE, NM 87113-1720
(505) 263-4066
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-4583
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
I-3599
NM
104100000X
Social Worker
C-3599
NM
1041C0700X
Clinical Social Worker
Primary
C-3599
NM
Other
Enumeration date
09/22/2016
Last updated
11/25/2024
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