Provider Demographics
NPI:1588817290
Name:ROLLINS, DENISE WINNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:WINNE
Last Name:ROLLINS
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 1:5885 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:EARLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13332-2607
Mailing Address - Country:US
Mailing Address - Phone:315-283-3970
Mailing Address - Fax:
Practice Address - Street 1:5885 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:EARLVILLE
Practice Address - State:NY
Practice Address - Zip Code:13332-2607
Practice Address - Country:US
Practice Address - Phone:315-283-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009443-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics