Individual
JASON SEBASTIAN COLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
690 ROUTE 9, GANSEVOORT, NY 12831-1409
(518) 584-8172
Mailing address
28 COOPER ST, LAKE GEORGE, NY 12845-1302
(916) 420-2754
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011121-01
NY
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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