Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 7628 | CA |
NPI | 1831254242 |
---|---|
Provider Name | Mrs. Julie Lanee Collins |
First Address | Vallejo, CA 94589-2441 |
Second Address | Vallejo, CA 94589-2441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 11/01/2022 |