Healthcare Provider Details
I. General information
NPI: 1376413294
Provider Name (Legal Business Name): ROZETTE MCLEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1074 SUMMIT AVE APT 4D
BRONX NY
10452-4615
US
IV. Provider business mailing address
1074 SUMMIT AVE APT 4D
BRONX NY
10452-4615
US
V. Phone/Fax
- Phone: 347-455-8489
- Fax:
- Phone: 347-455-8489
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: