Provider Demographics
NPI:1902941891
Name:ROSSOW, SHARON OWENS (COTA-L)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:OWENS
Last Name:ROSSOW
Suffix:
Gender:F
Credentials:COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 SE FOREST OAK LN
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-3260
Mailing Address - Country:US
Mailing Address - Phone:772-223-7375
Mailing Address - Fax:
Practice Address - Street 1:227 SW MONTEREY RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4646
Practice Address - Country:US
Practice Address - Phone:772-781-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 10181171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor