MEDICARE: LEAH ROSADO

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
1	103K00000X	Behavior Analyst	10893078-2506	UT
2	103K00000X	Behavior Analyst	550	HI

General Provider Information

NPI Number	:	1538602909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH ROSADO

Provider Business Mailing Address
First Line	:	1630 LIHOLIHO ST APT 1210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96822-2932
Country	:	US
Telephone Number	:	805-304-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 LIHOLIHO ST APT 1210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96822-2932
Country	:	US
Telephone Number	:	805-304-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	05/11/2023

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Directions to “ LEAH ROSADO ” Practice Location

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