Healthcare Provider Details

I. General information

NPI: 1427266022
Provider Name (Legal Business Name): MICHELLE SCHUSSEL ROSENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE ROSENBERG D/B/A THERAPEUTIC LEARNING LLC

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2674 OAK PARK CIR
DAVIE FL
33328-6722
US

IV. Provider business mailing address

2674 OAK PARK CIR
DAVIE FL
33328-6722
US

V. Phone/Fax

Practice location:
  • Phone: 954-536-2322
  • Fax:
Mailing address:
  • Phone: 954-536-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA 9165
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: