Individual
ROSA IRENA FOOTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1608 UNIVERSITY LN APT 1206, COCOA, FL 32922-5616
(407) 590-9931
Mailing address
PO BOX 237612, COCOA, FL 32923-7612
(407) 590-9931
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT4360
FL
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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