Provider Demographics
NPI:1316445448
Name:ROSENBERG, TERRI ANN (CSWI)
Entity type:Individual
Prefix:MISS
First Name:TERRI
Middle Name:ANN
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 GAZELLE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2722
Mailing Address - Country:US
Mailing Address - Phone:516-450-7434
Mailing Address - Fax:
Practice Address - Street 1:5900 W ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3304
Practice Address - Country:US
Practice Address - Phone:702-364-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical