Individual
AMANDA DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5 MIDDLESEX AVE, SOMERVILLE, MA 02145-1102
(617) 591-4600
Mailing address
5 MIDDLESEX AVE, SOMERVILLE, MA 02145-1102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11542
MA
Other
Enumeration date
05/25/2015
Last updated
05/25/2015
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