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General NPI Number Information
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NPI Number | 1255888939
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Entity Type | Organization
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Legal Business Name | JOSIE ROSENBERG LLC
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 19 OLD TOWN SQ UNIT 250M
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City | FORT COLLINS
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State | CO
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Zip | 80524-2471
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Country | US
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Telephone | 646-209-9728
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 W MULBERRY ST
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City | FORT COLLINS
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State | CO
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Zip | 80521-3520
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Country | US
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Telephone | 646-209-9728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSIE ROSENBERG
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Credential | LMFT
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Telephone | 646-209-9728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0001175
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License Number State | CO
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