Provider Demographics
NPI:1003107061
Name:COLLINS, LUCINDA VARN
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:VARN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LUCINDA
Other - Middle Name:MAREE
Other - Last Name:VARN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:413 S FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-2707
Mailing Address - Country:US
Mailing Address - Phone:919-563-2369
Mailing Address - Fax:
Practice Address - Street 1:1987 HILTON RD
Practice Address - Street 2:ALAMANCE HEALTH CARE CENTER
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217
Practice Address - Country:US
Practice Address - Phone:336-226-0848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0984OtherOCCUPATIONAL THERAPY NC LICENSE