Provider Demographics
NPI:1114775020
Name:ROSA, DEBORAH TORRES (SW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:TORRES
Last Name:ROSA
Suffix:
Gender:F
Credentials:SW
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:TORRES
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SW
Mailing Address - Street 1:673 CALLE ESCOLASTICO LOPEZ
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735-2834
Mailing Address - Country:US
Mailing Address - Phone:787-876-2042
Mailing Address - Fax:
Practice Address - Street 1:APARTADO 509 CARR. #188 INT. #187 LOIZA
Practice Address - Street 2:
Practice Address - City:CEIBA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-876-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13983104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker