Provider Demographics
NPI:1629897392
Name:DELAROSA, ROSSELYN GRECIL I
Entity type:Individual
Prefix:MS
First Name:ROSSELYN
Middle Name:GRECIL
Last Name:DELAROSA
Suffix:I
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 1:217 COLUMBIA RD APT 4217
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-3414
Mailing Address - Country:US
Mailing Address - Phone:857-214-9741
Mailing Address - Fax:
Practice Address - Street 1:217 COLUMBIA RD APT 4217
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-3414
Practice Address - Country:US
Practice Address - Phone:857-214-9741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician