Provider Demographics
NPI:1992155816
Name:CAMUSSO, ROCIO (OTR/L)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:CAMUSSO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 NORTHLAND DR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4945
Mailing Address - Country:US
Mailing Address - Phone:512-291-2669
Mailing Address - Fax:512-291-2666
Practice Address - Street 1:3303 NORTHLAND DR
Practice Address - Street 2:SUITE 312
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4945
Practice Address - Country:US
Practice Address - Phone:512-291-2669
Practice Address - Fax:512-291-2666
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist