Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 981 | MT |
NPI | 1427108679 |
---|---|
Provider Name | Mrs. Michelle Leann Rosen |
First Address | Bozeman, MT 59715-9248 |
Second Address | Bozeman, MT 59718-2739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 09/09/2016 |