| NPI | 1598267031 |
|---|---|
| Former Name | LORA JO ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY 175806) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY 174806) |
| 225X00000X Occupational Therapist (Licence: IN 31006550A) | |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2022-08-10 |