Individual
MR. ANDREW B DA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-0050
AZ
101YP2500X
Professional Counselor
Primary
LPC-12039
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094684
—
AZ
Enumeration date
09/28/2006
Last updated
08/24/2009
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