Provider Demographics
NPI:1386914836
Name:ROSIER, MARSHALL DEAN II (MS, LADC, CAC, MATS)
Entity type:Individual
Prefix:MR
First Name:MARSHALL
Middle Name:DEAN
Last Name:ROSIER
Suffix:II
Gender:M
Credentials:MS, LADC, CAC, MATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4341
Mailing Address - Country:US
Mailing Address - Phone:203-675-8328
Mailing Address - Fax:
Practice Address - Street 1:100 S TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4341
Practice Address - Country:US
Practice Address - Phone:203-675-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT726101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)