Individual
JACLYN MICHELLE BROOKE ROERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1790 SW 43RD WAY, FORT LAUDERDALE, FL 33317-5701
(855) 442-2454
(954) 206-7699
Mailing address
1790 SW 43RD WAY, FORT LAUDERDALE, FL 33317-5701
(855) 442-2454
(954) 206-7699
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17693
FL
225XP0200X
Pediatric Occupational Therapist
OT17693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018832000
—
FL
Enumeration date
09/13/2016
Last updated
11/21/2017
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