Provider Demographics
NPI:1841485042
Name:SPELLMAN, COLLEEN KAY (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:KAY
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 SUPERIOR ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4155
Mailing Address - Country:US
Mailing Address - Phone:402-742-7400
Mailing Address - Fax:402-742-9592
Practice Address - Street 1:2550 SUPERIOR ST
Practice Address - Street 2:SUITE 160
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4155
Practice Address - Country:US
Practice Address - Phone:402-742-7400
Practice Address - Fax:402-742-9592
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE281721Medicare UPIN