# MRS. COLLEEN B. WEITEKAMP

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417997628
- **Gender:** F
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 006609 | CT | Yes |
| 2251P0200X | Pediatric Physical Therapist | 006609 | CT | — |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 12/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 021239-1 | — | NY |