Davis, Rosalie

Davis, Rosalie is an sole proprietor health care provider with primary practice located at 3003 Louisiana Blvd Ne , Albuquerque NM 87110-2734. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Prescribing (Medical), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Davis, Rosalie can be contacted via phone (505) 881-0404.

Contact Information

Primary practice address
3003 Louisiana Blvd Ne Albuquerque NM 87110-2734
Fax: (505) 881-4654
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Prescribing (Medical) 103TP0016X 0009 New Mexico
Behavioral Health & Social Service Providers / Clinical 103TC0700X 137 New Mexico

Profile Details

NPI number 1265422703
LBN Legal business name Davis, Rosalie
Credentials PHD, RXP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2005
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265422703 NPPES
New Mexico MEDICAID N7893
New Mexico MEDICAID N0789

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