| Doctor Name: | MRS. MILDRED CUCHIE CANALS-ROSA |
| NPI Number: | 1194170902 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-R, ACSW |
| License Number: | R044382-1 |
| Business Practice Address: | 317 E. 17th St. New York City, NY - 10003 |
| Business Phone Number: | 2124205632 |
| Business Fax Number: | 2124202036 |
| Mailing Address: | 317 E. 17th St., NEW YORK CITY |
| State: | NY |
| Postal Code: | 10003 |
| Phone Number: | 2124205632 |
| Fax Number: | 2124202036 |
| NPI Enumeration Date: | 04/29/2016 |
| NPI Last Update Date: | 04/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R044382-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |