Provider Demographics
NPI:1376294744
Name:SNEAD, COLLEEN (OT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:SNEAD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 STONEMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-2399
Mailing Address - Country:US
Mailing Address - Phone:804-385-7280
Mailing Address - Fax:
Practice Address - Street 1:107 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1719
Practice Address - Country:US
Practice Address - Phone:757-776-3088
Practice Address - Fax:757-612-4499
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008498225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist