Provider Demographics
NPI:1477097293
Name:ROSADO, CAROLENA NATALIA
Entity type:Individual
Prefix:
First Name:CAROLENA
Middle Name:NATALIA
Last Name:ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 UTE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-2526
Mailing Address - Country:US
Mailing Address - Phone:702-845-1178
Mailing Address - Fax:
Practice Address - Street 1:4525 S SANDHILL RD
Practice Address - Street 2:SUIT 103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5954
Practice Address - Country:US
Practice Address - Phone:702-623-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103TR0400X103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation