Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT004857 | GA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT004857 | GA |
NPI | 1548532286 |
---|---|
Provider Name | Staci Rosing |
First Address | Atlanta, GA 30319-3706 |
Second Address | Atlanta, GA 30319-3706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2012 |
Last Update Date | 26/01/2012 |