Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 37600 | TX |
NPI | 1003043282 |
---|---|
Provider Name | Rosita Maria Waden-Brooks |
First Address | Houston, TX 77052-2687 |
Second Address | Baytown, TX 77521-2153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 22/03/2013 |