Provider Demographics
NPI:1871134874
Name:ROSSI, JULIA ROSE
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:ROSSI
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 1:14901 BOGLE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1736
Mailing Address - Country:US
Mailing Address - Phone:540-720-2261
Mailing Address - Fax:540-720-2261
Practice Address - Street 1:14901 BOGLE DR STE 100
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1736
Practice Address - Country:US
Practice Address - Phone:540-720-2261
Practice Address - Fax:540-720-2261
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist