Individual
MRS. KRISTINA BEA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 N ROCKTON AVE, ROCKFORD, IL 61103-3655
(815) 968-6861
Mailing address
211 FAIRWOOD PL, ROCKTON, IL 61072-2951
(815) 742-8274
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.002698
IL
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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