Provider Demographics
NPI:1942710892
Name:COLLINS, JESSICA F (OT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:F
Last Name:COLLINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:163 LIBBEY INDUSTRIAL PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3137
Mailing Address - Country:US
Mailing Address - Phone:781-335-6663
Mailing Address - Fax:
Practice Address - Street 1:163 LIBBEY INDUSTRIAL PKWY STE 302
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189
Practice Address - Country:US
Practice Address - Phone:781-335-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12725225X00000X
TX118594225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118594OtherSTATE OF TEXAS OCCUPATIONAL THERAPY LICENSE