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General NPI Number Information
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NPI Number | 1861139057
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Entity Type | Individual
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Provider Name | ZACAHREAH SALEEM COLLINS SIR
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Gender | Male
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 314 ALBERT ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-4849
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Country | US
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Telephone | 206-476-7292
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Fax |
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Provider Business Mailing Address
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Address Line | 932 SW 108TH ST
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City | BURIEN
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State | WA
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Zip | 98146-2192
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Country | US
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Telephone | 206-476-7292
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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 | 224ZE0001X
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Taxonomy Name | Environmental Modification Occupational Therapy Assistant
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License Number | 224ZE604607126X
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License Number State | WA
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