Provider Demographics
NPI:1609376540
Name:COLLIER, VERONICA YAMILET (COTA/L)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:YAMILET
Last Name:COLLIER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:YAMILET
Other - Last Name:MARROQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2110 N INGLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-9417
Mailing Address - Country:US
Mailing Address - Phone:479-220-7984
Mailing Address - Fax:
Practice Address - Street 1:2110 N INGLEWOOD ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-9417
Practice Address - Country:US
Practice Address - Phone:479-220-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1110224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant