MEDICARE: IRINA COLLINS OTR L

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	OC009985	PA

General Provider Information

NPI Number	:	1528136611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRINA COLLINS OTR L

Provider Business Mailing Address
First Line	:	406 ECHOWOOD DR
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2829
Country	:	US
Telephone Number	:	724-295-9415
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 ECHOWOOD DR
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2829
Country	:	US
Telephone Number	:	724-295-9415
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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