Provider Demographics
NPI:1689901191
Name:ROSSER, LESLEY (OT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:ROSSER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:336-886-1247
Practice Address - Street 1:110 SCOTT AVE. SUITE 3
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2843
Practice Address - Country:US
Practice Address - Phone:336-207-8957
Practice Address - Fax:336-886-1247
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1914225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics