Healthcare Provider Details

I. General information

NPI: 1043175730
Provider Name (Legal Business Name): DANICA ROSENE RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1387 N GALENA AVE
DIXON IL
61021-1009
US

IV. Provider business mailing address

1387 N GALENA AVE
DIXON IL
61021-1009
US

V. Phone/Fax

Practice location:
  • Phone: 815-440-6134
  • Fax: 855-790-7045
Mailing address:
  • Phone: 815-440-6134
  • Fax: 855-790-7045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: