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Organization

MOSAIC REMEDIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VANESSA MARIE COLONNA OTR/L (OCCUPATIONAL THERAPIST)
(562) 208-1980
Entity
Organization

Contact information

Practice address
752 DIANE AVE, LAS VEGAS, NM 87701-4910
(562) 208-1980
Mailing address
752 DIANE AVE, LAS VEGAS, NM 87701-4910
(562) 208-1980

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02021976
NM
Enumeration date
05/08/2026
Last updated
05/08/2026
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