Basic Information
| Provider Information | |||||||||
| NPI: | 1386229680 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENBERG | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4803 ATLANTIS CT APT 6 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284036439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186493011 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5710 OLEANDER DR STE 112 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284034722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104521460 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2021 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A14890 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.