Healthcare Provider Details

I. General information

NPI: 1932605359
Provider Name (Legal Business Name): EMILY ROSE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 S HOLLY CIR STE 200
CENTENNIAL CO
80112-1066
US

IV. Provider business mailing address

31715 CREEKSIDE DR
PEPPER PIKE OH
44124-5207
US

V. Phone/Fax

Practice location:
  • Phone: 720-287-4185
  • Fax:
Mailing address:
  • Phone: 216-926-8594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: