Individual
MRS. JACQUELINE ROSELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1011 BERKS ROAD, LEESPORT, PA 19533
(610) 376-4841
Mailing address
2407 LASALLE DR, WEST LAWN, PA 19609-1216
(610) 670-9511
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP000212L
PA
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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