Individual
MRS. COLLEEN ANNE WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
171 INTREPID LN, SYRACUSE, NY 13205
(315) 437-4689
Mailing address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009654-1
NY
Other
Enumeration date
01/13/2017
Last updated
06/06/2018
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