Provider Demographics
NPI:1912798877
Name:AMPARO, ROSAURIS DEAGELIN
Entity type:Individual
Prefix:
First Name:ROSAURIS
Middle Name:DEAGELIN
Last Name:AMPARO
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 1:9 NEEDHAMS LANDING RD APT 106
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-2192
Mailing Address - Country:US
Mailing Address - Phone:781-548-7165
Mailing Address - Fax:
Practice Address - Street 1:12 GILL ST STE 1400
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1753
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician