Individual
COLIN NULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3998 FAIR RIDGE DR STE 100-B, FAIRFAX, VA 22033-2907
(703) 934-0333
Mailing address
1318 ALDBURY WAY, RESTON, VA 20194-1428
(703) 509-4470
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119009956
VA
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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