Provider Demographics
NPI:1740923929
Name:MCCOLLUM, EMILY ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:MCCOLLUM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 SYLVESTOR PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6202
Mailing Address - Country:US
Mailing Address - Phone:303-949-8540
Mailing Address - Fax:
Practice Address - Street 1:222 SYLVESTOR PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6202
Practice Address - Country:US
Practice Address - Phone:303-949-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007350225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics