Individual
BERENIS ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6426 W RIVERCHASE DR BLDG 33, TEMPLE TERRACE, FL 33637-5658
(718) 764-9423
Mailing address
6426 W RIVERCHASE DR BLDG 33, TEMPLE TERRACE, FL 33637-5658
(718) 764-9423
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UB30302W
—
NY
Enumeration date
05/20/2021
Last updated
05/20/2021
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