Provider Demographics
NPI:1669674297
Name:HAIRE, ROSE ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANN
Last Name:HAIRE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:ROSE
Other - Middle Name:ANN
Other - Last Name:KOPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:104 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1739
Mailing Address - Country:US
Mailing Address - Phone:814-937-9530
Mailing Address - Fax:
Practice Address - Street 1:750 E PARK DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2758
Practice Address - Country:US
Practice Address - Phone:717-561-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC007337L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist