Individual
MRS. LACRECIA ROSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
240 HEDGEROW TRL, FAYETTEVILLE, GA 30214-7270
(678) 485-9882
Mailing address
240 HEDGEROW TRL, FAYETTEVILLE, GA 30214-7270
(678) 485-9882
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
OT003321
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753263090A
—
GA
Enumeration date
09/11/2008
Last updated
10/22/2014
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