Individual
COLLEEN MARY FLETCHER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1912 MEMORIAL AVE, LYNCHBURG, VA 24501-1708
(434) 845-8765
Mailing address
1007 WESTVIEW DR, LYNCHBURG, VA 24502-1752
(434) 845-8765
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003567
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192596
ANTHEM BC/BS
VA
Enumeration date
06/14/2006
Last updated
07/08/2007
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