Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT21858 | FL |
NPI | 1003482274 |
---|---|
Provider Name | Brittany Nicole Collins |
First Address | Clermont, FL 34711-1907 |
Second Address | Clermont, FL 34711-1907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2021 |
Last Update Date | 28/05/2021 |