Provider Demographics
NPI:1790132942
Name:ROSALLI, HOPA
Entity Type:Individual
Prefix:
First Name:HOPA
Middle Name:
Last Name:ROSALLI
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 1:10 MERCHANTS ROW
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753
Mailing Address - Country:US
Mailing Address - Phone:802-310-4015
Mailing Address - Fax:
Practice Address - Street 1:10 MERCHANTS ROW
Practice Address - Street 2:SUITE 209
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1421
Practice Address - Country:US
Practice Address - Phone:802-310-4015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist