Individual
BECKY ROOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
516 3RD ST STE 100, DES MOINES, IA 50309-1771
(515) 309-4706
Mailing address
2921 88TH CT, URBANDALE, IA 50322-4209
(515) 276-0199
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00980
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00980
LICENSE NUMBER
IA
Enumeration date
05/22/2007
Last updated
07/08/2007
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