Provider Demographics
NPI:1043613524
Name:ROZEN, ALYCIA
Entity Type:Individual
Prefix:MS
First Name:ALYCIA
Middle Name:
Last Name:ROZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 GOLDEN AVE
Mailing Address - Street 2:UNIT 11
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2065
Mailing Address - Country:US
Mailing Address - Phone:513-321-1329
Mailing Address - Fax:
Practice Address - Street 1:3450 GOLDEN AVE
Practice Address - Street 2:UNIT 11
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-2065
Practice Address - Country:US
Practice Address - Phone:513-321-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001215225XM0800X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health