Provider Demographics
NPI:1609083633
Name:SWIFT, COLLEEN HELEN (OTR)
Entity Type:Individual
Prefix:MISS
First Name:COLLEEN
Middle Name:HELEN
Last Name:SWIFT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 OLEAN ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:NY
Mailing Address - Zip Code:14715-1304
Mailing Address - Country:US
Mailing Address - Phone:585-928-2248
Mailing Address - Fax:
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1513
Practice Address - Country:US
Practice Address - Phone:716-375-7481
Practice Address - Fax:716-375-6410
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007984-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist