MEDICARE: CONNIE JANE COLLINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	5535	OH

General Provider Information

NPI Number	:	1366690133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE JANE COLLINSON

Provider Business Mailing Address
First Line	:	7 CARNEGIE PLZ
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1000
Country	:	US
Telephone Number	:	877-407-3422
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 AUBURN DR STE 200
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4328
Country	:	US
Telephone Number	:	877-407-3422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	10/11/2021

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Directions to “ CONNIE JANE COLLINSON ” Practice Location

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