Doctor Name: | ROSE MARIE BERNARDEZ |
NPI Number: | 1104108737 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | 2006019053 |
Business Practice Address: | 2634 Highway 109 Suite E Wildwood, MO - 630401160 |
Business Phone Number: | 3148022599 |
Business Fax Number: | 6362739813 |
Mailing Address: | 2634 Highway 109, Suite E WILDWOOD |
State: | MO |
Postal Code: | 630401160 |
Phone Number: | 3148022599 |
Fax Number: | 6362739813 |
NPI Enumeration Date: | 09/09/2011 |
NPI Last Update Date: | 09/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2006019053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |