Individual
SEBASTIAN LUIS COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
875 ROUTE 73 N STE B, MARLTON, NJ 08053-1273
(856) 985-3336
Mailing address
465 PARK AVE FL 1, COLLINGSWOOD, NJ 08108-3076
(609) 477-3351
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00803100
NJ
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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