Provider Demographics
NPI:1871759282
Name:COLLINS, CATHERINE (OT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:966 N GARDEN RIDGE BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2876
Mailing Address - Country:US
Mailing Address - Phone:972-420-6605
Mailing Address - Fax:972-436-2770
Practice Address - Street 1:966 N GARDEN RIDGE BLVD STE 530
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2876
Practice Address - Country:US
Practice Address - Phone:972-420-6605
Practice Address - Fax:972-436-2770
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-003443225X00000X
TX116301225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
12121200OtherCAQH ID