Individual
MRS. BRENDA M ROLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
302 STRASBURG DR, PORT CHARLOTTE, FL 33954-3305
(941) 204-2695
Mailing address
302 STRASBURG DR, PORT CHARLOTTE, FL 33954-3305
(941) 204-2695
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OT 3382
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008510600
—
FL
Enumeration date
08/20/2009
Last updated
05/20/2013
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