Individual
MRS. MISTY DAWN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
60 PHILLIPS BRANCH RD, PHELPS, KY 41553-9061
(606) 456-8725
Mailing address
60 PHILLIPS BRANCH RD, PHELPS, KY 41553-9061
(606) 456-8725
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131000905
VA
224Z00000X
Occupational Therapy Assistant
Primary
A4901
KY
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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