Provider Demographics
NPI:1437950383
Name:REYES-ROSAS, ERICA MARIE
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:REYES-ROSAS
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 1:3413 FERNDALE DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-4256
Mailing Address - Country:US
Mailing Address - Phone:254-424-5477
Mailing Address - Fax:
Practice Address - Street 1:2201 MACARTHUR DR STE 100
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3159
Practice Address - Country:US
Practice Address - Phone:254-202-6519
Practice Address - Fax:254-202-7149
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical