Provider Demographics
NPI:1063786937
Name:ROSARIO, EMMA INES (OTL)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:INES
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CALLE TULANE
Mailing Address - Street 2:COND UNIVERSITY PLAZA APT 46
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4943
Mailing Address - Country:US
Mailing Address - Phone:787-479-7465
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE TULANE
Practice Address - Street 2:COND UNIVERSITY PLAZA APT 46
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4943
Practice Address - Country:US
Practice Address - Phone:787-479-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR848225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics