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NPI Code Detail

MEDICARE: HEATHER E ROSALES LMSW

MEDICARE: HEATHER E ROSALES LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6801093659MI

General Provider Information

NPI Number : 1063759975
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER E ROSALES LMSW
Provider Business Mailing Address
First Line : PO BOX 10
Second Line :
City : MASON
State : MI
Zip : 48854-0010
Country : US
Telephone Number : 517-881-4326
Fax Number :
Provider Business Practice Location Address
First Line : 411 W LAKE LANSING RD STE A100
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-8404
Country : US
Telephone Number : 517-881-4326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2013
Last Update Date : 11/10/2022

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Directions to “ HEATHER E ROSALES LMSW” Practice Location

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