Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC003591L | PA |
N | 225XE0001X | Environmental Modification | OC003591L | PA |
N | 225XF0002X | Feeding, Eating & Swallowing | OC003591L | PA |
N | 225XM0800X | Mental Health | OC003591L | PA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC003591L | PA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC003591L | PA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC003591L | PA |
NPI | 1811299381 |
---|---|
Provider Name | Stacy Sue Rosello |
First Address | Pittsburgh, PA 15241-1564 |
Second Address | Pittsburgh, PA 15241-1564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 03/12/2010 |