Provider Demographics
NPI:1932827854
Name:ROSENBERG, DENISE MARLENE (CCC SLP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARLENE
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MARLENE
Other - Last Name:HYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC SLP
Mailing Address - Street 1:25060 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2018
Mailing Address - Country:US
Mailing Address - Phone:248-850-0505
Mailing Address - Fax:313-447-2700
Practice Address - Street 1:25060 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-850-0505
Practice Address - Fax:313-447-2700
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist