NPI Code Details Logo

NPI 1962051243

NPI 1962051243 : COLLEEN MARY DILLON OTD : LAS VEGAS, NV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1962051243
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    COLLEEN MARY DILLON OTD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/09/2019
-----------------------------------------------------
    Last Update Date     |    01/12/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    9121 W RUSSELL RD STE 115 
-----------------------------------------------------
    City                 |    LAS VEGAS
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89148-1238
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    702-499-6638
-----------------------------------------------------
    Fax                  |    702-442-8929
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    9121 W RUSSELL RD STE 115 
-----------------------------------------------------
    City                 |    LAS VEGAS
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89148-1238
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    702-499-6638
-----------------------------------------------------
    Fax                  |    702-442-8929
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    OT-2349
-----------------------------------------------------
    License Number State |    NV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225XP0200X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Occupational Therapist
-----------------------------------------------------
    License Number       |    OT-2349
-----------------------------------------------------
    License Number State |    NV
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.