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General NPI Number Information
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NPI Number | 1053917013
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Entity Type | Individual
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Provider Name | MICHEL ROSARIO LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 510 E STONER AVE
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City | SHREVEPORT
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State | LA
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Zip | 71101-4243
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Country | US
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Telephone | 318-221-8411
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Fax |
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Provider Business Mailing Address
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Address Line | 7333 NEW HAMPSHIRE AVE APT 307
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6959
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Country | US
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Telephone | 202-679-1343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC200002115
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License Number State | DC
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