Doctor Name: | ROZI P WAX |
NPI Number: | 1053482653 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 39001347A |
Business Practice Address: | 113 Lincoln Way East Mishawaka, IN - 465442016 |
Business Phone Number: | 5742554976 |
Business Fax Number: | 5742551882 |
Mailing Address: | 113 Lincoln Way East, MISHAWAKA |
State: | IN |
Postal Code: | 465442016 |
Phone Number: | 5742554976 |
Fax Number: | 5742551882 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39001347A |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |