Provider Demographics
NPI:1538602909
Name:ROSADO, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:ROSADO
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 1:1630 LIHOLIHO ST APT 1210
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2932
Mailing Address - Country:US
Mailing Address - Phone:805-304-2424
Mailing Address - Fax:
Practice Address - Street 1:1630 LIHOLIHO ST APT 1210
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2932
Practice Address - Country:US
Practice Address - Phone:805-304-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10893078-2506103K00000X
HI550103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst