Individual
BREANNA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
127 CARTER ST, RICHMOND HILL, GA 31324-3753
(910) 750-5989
Mailing address
800 PRESERVE AVE E APT 8307, PORT ROYAL, SC 29935-2605
(910) 750-5989
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA002692
GA
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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