Individual
MRS. KATHLEEN GRACE ROSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
165 JOHNSON CIR, LOCKESBURG, AR 71846-9032
(870) 557-6102
Mailing address
165 JOHNSON CIR, LOCKESBURG, AR 71846-9032
(870) 557-6102
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215592
TX
225XP0200X
Pediatric Occupational Therapist
215592
TX
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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