Individual
MRS. ROSEMARIE DUTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3109 EFFINGHAM DR, CLERMONT, FL 34714-6168
(407) 951-0844
Mailing address
3109 EFFINGHAM DR, CLERMONT, FL 34714-6168
(407) 951-0844
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D360737879700
FL DRIVERS LICENSE
FL
Enumeration date
07/07/2017
Last updated
07/07/2017
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