Provider Demographics
NPI:1922311125
Name:HERRMANN, ROSALIE GRACE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ROSALIE
Middle Name:GRACE
Last Name:HERRMANN
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 1:8 WINDRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1468
Mailing Address - Country:US
Mailing Address - Phone:716-639-0917
Mailing Address - Fax:
Practice Address - Street 1:8 WINDRIDGE CT
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-1468
Practice Address - Country:US
Practice Address - Phone:716-639-0917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006592-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist