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Individual

ROSE JOSEFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Mailing address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I4209
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
B7596
NM
Enumeration date
10/10/2006
Last updated
07/08/2007
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