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General NPI Number Information
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NPI Number | 1194190678
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Entity Type | Individual
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Provider Name | STACEY ROSSELOT OTD, MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 525 E MARKET ST
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City | AKRON
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State | OH
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Zip | 44304-1619
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Country | US
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Telephone | 330-375-3168
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Fax |
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Provider Business Mailing Address
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Address Line | 622 BERRY RD
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City | HOWARD
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State | OH
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Zip | 43028-9542
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Country | US
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Telephone | 740-263-7231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 009143
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License Number State | OH
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