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Individual

KRISTI LAUREN COLLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
12052 N SHORE DR, RESTON, VA 20190-4969
(703) 834-9800
Mailing address
8300 WYOMING BLVD NE, ALBUQUERQUE, NM 87113-1997
(240) 818-1995

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006984
VA
225X00000X
Occupational Therapist
06813
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467726265
MED B
VA
Enumeration date
02/27/2012
Last updated
11/19/2021
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