Individual
CARMEN ROSALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/ L
Contact information
Practice address
10331 COPPER TREE PL, FORT WAYNE, IN 46804-4284
(260) 446-9685
Mailing address
10331 COPPER TREE PL, FORT WAYNE, IN 46804-4284
(260) 446-9685
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006665A
IN
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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