MEDICARE: ALICIA M ROSAS

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1851860431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA M ROSAS

Provider Business Mailing Address
First Line	:	10916 CHESTNUT HILL DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-7602
Country	:	US
Telephone Number	:	703-577-9757
Fax Number	:

Provider Business Practice Location Address
First Line	:	10916 CHESTNUT HILL DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-7602
Country	:	US
Telephone Number	:	703-577-9757
Fax Number	:

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

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	11/13/2018

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Directions to “ ALICIA M ROSAS ” Practice Location

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