Healthcare Provider Details

I. General information

NPI: 1346965464
Provider Name (Legal Business Name): KATHLEEN COLE ROSEEN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 EASTMAN RD STE C
CENTER CONWAY NH
03813-4219
US

IV. Provider business mailing address

626 EASTMAN RD STE A
CENTER CONWAY NH
03813-4219
US

V. Phone/Fax

Practice location:
  • Phone: 603-447-4356
  • Fax: 603-447-4358
Mailing address:
  • Phone: 603-447-3347
  • Fax: 603-447-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0164
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: