Individual
DIANNE ROOSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 COLEMAN DR, ST AUGUSTINE, FL 32084-2873
(727) 967-1036
Mailing address
2 COLEMAN DR, ST AUGUSTINE, FL 32084-2873
(727) 967-1036
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA16247
FL
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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