Provider Demographics
NPI:1437389988
Name:COLLIER, CLELLA C (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CLELLA
Middle Name:C
Last Name:COLLIER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:CLELLA
Other - Middle Name:
Other - Last Name:LANNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1898 FORT RD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-8320
Mailing Address - Country:US
Mailing Address - Phone:307-672-3473
Mailing Address - Fax:307-672-1941
Practice Address - Street 1:1898 FORT RD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-8320
Practice Address - Country:US
Practice Address - Phone:307-672-3473
Practice Address - Fax:307-672-1941
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0624225X00000X
WYOTR-812225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist