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NPI Code Detail

MEDICARE: HEATHER ROSIAK

MEDICARE: HEATHER ROSIAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor37AC00368400NJ

General Provider Information

NPI Number : 1710560974
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER ROSIAK
Provider Business Mailing Address
First Line : 8 CASTOR CT
Second Line :
City : BLACKWOOD
State : NJ
Zip : 08012-2445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1103 SHEPPARD RD
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-4797
Country : US
Telephone Number : 609-904-3933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2021
Last Update Date : 05/04/2021

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Directions to “ HEATHER ROSIAK ” Practice Location

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