# MRS. THEODORA COLBURN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508111964
- **Gender:** F
- **Credential:** BA BS RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM1400X | Nurse Massage Therapist (NMT) | RN118502 | MA | Yes |
| 364SR0400X | Rehabilitation Clinical Nurse Specialist | RN118502 | MA | — |

## Other

- **Enumeration date:** 07/20/2012
- **Last updated:** 07/20/2012