Individual
MS. BRENDA ILLENE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
523 CAPE CORAL PKWY E, CAPE CORAL, FL 33904-8545
(239) 549-7161
(239) 549-7134
Mailing address
PO BOX 372, ST JAMES CITY, FL 33956-0372
(239) 699-4658
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10038
FL
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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