MEDICARE: MS. ANITA MICHELLE ROSE L.O.T.R.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	Z11193	LA
2	225XP0200X	Pediatric Occupational Therapist	Z11193	LA

General Provider Information

NPI Number	:	1386866036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANITA MICHELLE ROSE L.O.T.R.

Provider Business Mailing Address
First Line	:	250 HIDDEN HILLS RD
Second Line	:
City	:	ARNAUDVILLE
State	:	LA
Zip	:	70512-6430
Country	:	US
Telephone Number	:	337-654-4202
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 HIDDEN HILLS RD
Second Line	:
City	:	ARNAUDVILLE
State	:	LA
Zip	:	70512-6430
Country	:	US
Telephone Number	:	337-654-4202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/11/2025

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