Provider Demographics
NPI:1922394170
Name:CASALI, ROSA E (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:E
Last Name:CASALI
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:E
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9344 SW 170 LANE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:305-710-0029
Mailing Address - Fax:
Practice Address - Street 1:9011 SW 157TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1939
Practice Address - Country:US
Practice Address - Phone:305-710-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-14-17111103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst