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General NPI Number Information
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NPI Number | 1053407171
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Entity Type | Individual
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Provider Name | JOAN MARIE COLLINS OTR CHT
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 7373 FRANCE AVENUE SOUTH #509
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City | EDINA
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State | MN
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Zip | 55435
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Country | US
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Telephone | 952-830-0069
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Fax | 612-925-1123
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Provider Business Mailing Address
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Address Line | 7801 EAST BUSH LAKE RD. #320
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City | BLOOMINGTON
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State | MN
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Zip | 55439
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Country | US
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Telephone | 952-831-5773
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Fax | 952-831-7224
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 100327
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 100327
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License Number State | MN
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