Healthcare Provider Details

I. General information

NPI: 1164923488
Provider Name (Legal Business Name): BRIANA ELLEN ROSINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 TELEGRAPH RD
TAYLOR MI
48180-3330
US

IV. Provider business mailing address

18513 TRAIL RIDGE CT
BROWNSTOWN MI
48174-9313
US

V. Phone/Fax

Practice location:
  • Phone: 313-295-5000
  • Fax:
Mailing address:
  • Phone: 734-624-9627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201009489
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: