Provider Demographics
NPI:1033693593
Name:COLSON, EMILY (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:COLSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16635 CENTERFIELD DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577
Mailing Address - Country:US
Mailing Address - Phone:615-695-2277
Mailing Address - Fax:615-577-5654
Practice Address - Street 1:16635 CENTERFIELD DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577
Practice Address - Country:US
Practice Address - Phone:906-694-6002
Practice Address - Fax:907-694-6015
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK207924225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1739196Medicaid