Provider Demographics
NPI:1437915287
Name:ROSATO, MADISON F
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:F
Last Name:ROSATO
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 1:5220 CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4170
Mailing Address - Country:US
Mailing Address - Phone:334-559-1267
Mailing Address - Fax:
Practice Address - Street 1:3623 CALVIN DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7915
Practice Address - Country:US
Practice Address - Phone:706-940-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty