Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 14141 | FL |
NPI | 1073820098 |
---|---|
Provider Name | Deanne Rosselli |
First Address | Stuart, FL 34997-5460 |
Second Address | Stuart, FL 34997-5460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2010 |
Last Update Date | 13/09/2010 |