Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 007574 | NY |
NPI | 1003094475 |
---|---|
Provider Name | Ms. Veda Marie Collmer |
First Address | Glendale, AZ 85310-2910 |
Second Address | Glendale, AZ 85310-2910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2008 |
Last Update Date | 08/11/2013 |