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General NPI Number Information
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NPI Number | 1336864594
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Entity Type | Organization
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Legal Business Name | TREELINE ENRICHMENT, LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 701 SPARKMAN RD
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City | PLANT CITY
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State | FL
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Zip | 33566-4709
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Country | US
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Telephone | 863-271-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 4814 HIGHLANDS PLACE DR
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City | LAKELAND
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State | FL
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Zip | 33813-2163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA ROSENBURG
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Credential | OTD, OTR/L
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Telephone | 863-224-0198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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