Provider Demographics
NPI:1548740178
Name:ROSEN, ALLISON (OTR)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:22380 FM 2484
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5076
Mailing Address - Country:US
Mailing Address - Phone:432-940-2153
Mailing Address - Fax:
Practice Address - Street 1:1373 N AVENUE C
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-1528
Practice Address - Country:US
Practice Address - Phone:512-285-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist