Individual
ROSANNA BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3034 KINGSBRIDGE AVE APT 2CS, BRONX, NY 10463-5147
(917) 689-0072
Mailing address
3034 KINGSBRIDGE AVE APT 2CS, BRONX, NY 10463-5147
(917) 689-0072
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1378866202
NY
174400000X
Specialist
—
—
Other
Enumeration date
11/04/2013
Last updated
08/27/2021
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