MEDICARE: COLLEEN MARY DILLON OTD

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	OT-2349	NV
2	225XP0200X	Pediatric Occupational Therapist	OT-2349	NV

General Provider Information

NPI Number	:	1962051243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN MARY DILLON OTD

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

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

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

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	01/12/2026

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Directions to “ COLLEEN MARY DILLON OTD” Practice Location

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