Individual
COLLEEN A DANIELS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC, ATTN: CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
11050 MT BELVEDERE BLVD, ATTN: CREDENTIALS USAMEDDAC, FORT DRUM, NY 13602-5004
(315) 772-4025
(315) 772-9498
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109058
TX
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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