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General NPI Number Information
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NPI Number | 1508385568
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Entity Type | Individual
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Provider Name | ROSALIE ANN CAMACHO-COLLIER LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 232 MARKET ST
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City | FLOWOOD
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State | MS
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Zip | 39232-3339
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Country | US
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Telephone | 323-205-7088
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Fax | 833-419-0181
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Provider Business Mailing Address
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Address Line | 400 E FLOYCE ST
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City | RULEVILLE
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State | MS
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Zip | 38771-3922
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Country | US
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Telephone | 401-626-7313
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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 | ISW02926
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C11636
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License Number State | MS
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