Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 18338 | FL |
NPI | 1003488560 |
---|---|
Provider Name | Marsha Collins |
First Address | Marianna, FL 32446-2515 |
Second Address | Tallahassee, FL 32308-4497 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2021 |
Last Update Date | 14/07/2021 |