Individual
VICTORIA ROSALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3410 SUNSET BLVD, WEST COLUMBIA, SC 29169-3042
(864) 757-9918
(864) 757-9921
Mailing address
219 GERALD DR, SIMPSONVILLE, SC 29681-4111
(864) 757-9918
(864) 757-9921
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36535
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BA1346
—
SC
Enumeration date
09/22/2016
Last updated
04/01/2022
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