Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OCO10026 | PA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC010026 | PA |
NPI | 1114178746 |
---|---|
Provider Name | Mrs. Colleen Marie Delgaizo |
First Address | Pottstown, PA 19464 |
Second Address | Pottstown, PA 19464-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 27/08/2021 |