Provider Demographics
NPI:1366919946
Name:CHAVEZ, ROSIBEL MARIE
Entity type:Individual
Prefix:
First Name:ROSIBEL
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3119
Mailing Address - Country:US
Mailing Address - Phone:570-202-6720
Mailing Address - Fax:
Practice Address - Street 1:57 HOPE ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3119
Practice Address - Country:US
Practice Address - Phone:570-202-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst