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NPI 1952569741

NPI 1952569741 : NANCY L COLLEY : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1952569741
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    Entity Type          |    Individual 
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    Provider Name        |    NANCY L COLLEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/28/2008
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    Last Update Date     |    06/12/2008
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Provider Practice Location Address
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    Address Line         |    6223 BEECHMONT BLVD 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32808-2317
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    Country              |    US
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    Telephone            |    407-780-0585
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6223 BEECHMONT BLVD 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32808-2317
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    Country              |    US
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    Telephone            |    407-780-0585
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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        |    103TM1800X
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    Taxonomy Name        |    Intellectual & Developmental Disabilities Psychologist
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    License Number       |    
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    License Number State |    
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