Individual
ROBERTA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
15822 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 220-1681
Mailing address
9754 TRESCOTT AVE, OVERLAND, MO 63114-3540
(314) 346-4818
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2014002580
MO
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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