Individual
FAYE COLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
922 6TH AVE SE, DECATUR, AL 35601-3907
(256) 309-0454
(256) 309-0422
Mailing address
18344 ROCKY HILL LN, ATHENS, AL 35613-5643
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2214
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2214
OT LICENSE
AL
01
—
515-93473
BCBS
AL
Enumeration date
04/16/2007
Last updated
11/17/2008
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