Provider Demographics
NPI:1326842899
Name:ROSIN, ANAIS (BCBA)
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:ROSIN
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 SAN MARIE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-3230
Mailing Address - Country:US
Mailing Address - Phone:786-848-8979
Mailing Address - Fax:
Practice Address - Street 1:1315 MACOM DR STE 103
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9360
Practice Address - Country:US
Practice Address - Phone:630-585-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152.001133103K00000X
NY1-25-79728103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst