Individual
MRS. COLLEEN GRAY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
910 LIA ST, PATTERSON, LA 70392-4220
(985) 395-4563
Mailing address
306 CHARLOTTE DR, PATTERSON, LA 70392-4148
(985) 714-0923
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10870
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z10870
OCCUPATIONAL THERAPY LICENSE NUMBER
LA
Enumeration date
07/31/2008
Last updated
07/31/2008
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