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General NPI Number Information
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NPI Number | 1194109546
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Entity Type | Individual
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Provider Name | JUSTINE A. COLSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 1371 HARVARD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20009-4903
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Country | US
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Telephone | 202-674-0424
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Fax |
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Provider Business Mailing Address
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Address Line | 12208 BRADBURY DR
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City | GAITHERSBURG
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State | MD
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Zip | 20878-2013
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Country | US
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Telephone | 301-613-3090
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Fax |
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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 | 13423
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 08533
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010001082
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License Number State | DC
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