Provider Demographics
NPI:1881431054
Name:MILLHOUSE, ROSALEE
Entity type:Individual
Prefix:
First Name:ROSALEE
Middle Name:
Last Name:MILLHOUSE
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 1:4320 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135
Mailing Address - Country:US
Mailing Address - Phone:267-718-2340
Mailing Address - Fax:
Practice Address - Street 1:1000 YORK RD. FIRST FL
Practice Address - Street 2:
Practice Address - City:UPPER MORELAND-WILLOW GROVE, PA
Practice Address - State:PA
Practice Address - Zip Code:19090
Practice Address - Country:US
Practice Address - Phone:21552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG015786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist