Provider Demographics
NPI:1811451115
Name:ROSARIO, CELESTINA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:CELESTINA
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CELY
Other - Middle Name:
Other - Last Name:ROSARIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:166 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1910
Mailing Address - Country:US
Mailing Address - Phone:978-513-7242
Mailing Address - Fax:
Practice Address - Street 1:166 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1910
Practice Address - Country:US
Practice Address - Phone:978-513-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12053225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist