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Individual

MRS. DIANE LYNN COLLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
413 MCCLELLAN ST, BERRYVILLE, VA 22611-1420
(540) 955-2802
Mailing address
527 OLD CHARLES TOWN RD, STEPHENSON, VA 22656-1822
(540) 722-3864

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000084
VA

Other

Enumeration date
09/29/2010
Last updated
09/29/2010
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