Individual
MRS. REVA JO ROSELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1411 AMARILLO BLVDE, AMARILLO, TX 79107-5555
(806) 351-7200
Mailing address
PO BOX 5884, AMARILLO, TX 79117-5884
(806) 351-7200
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
14002
TX
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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