| Doctor Name: | JACKIE ROSENBERGER |
| NPI Number: | 1205820545 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | 40193 |
| Business Practice Address: | 1181 Sharpshire Ct Waxahachie, TX - 751656330 |
| Business Phone Number: | 2143993918 |
| Business Fax Number: | |
| Mailing Address: | 1181 Sharpshire Ct, WAXAHACHIE |
| State: | TX |
| Postal Code: | 751656330 |
| Phone Number: | 2143993918 |
| Fax Number: | |
| NPI Enumeration Date: | 09/01/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/24/2006 |
| NPI Reactivation Date: | 05/22/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 40193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |