Individual
JENNIFER B ROOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
OT01061
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0614
NHPRI
RI
05
—
ES01788
—
RI
01
—
SB870
BCRI
RI
Enumeration date
07/19/2006
Last updated
05/09/2024
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