Individual
MRS. ELIZABETH ANN COLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6722 WHITE FEATHER RD, JOSHUA TREE, CA 92252-6605
(760) 365-6909
Mailing address
57854 BELMONT ST, YUCCA VALLEY, CA 92284-8620
(760) 365-6909
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 758
CA
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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