Healthcare Provider Details

I. General information

NPI: 1417881251
Provider Name (Legal Business Name): CORINNA ROSSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7820 BALTUSROL BLVD
GAINESVILLE VA
20155-3270
US

IV. Provider business mailing address

110 HORIZON DR STE 310
RALEIGH NC
27615-4926
US

V. Phone/Fax

Practice location:
  • Phone: 703-468-2750
  • Fax:
Mailing address:
  • Phone: 919-424-5080
  • Fax: 919-431-9224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011388
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: