Provider Demographics
NPI:1154585099
Name:COLLINS, DIANE LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 MERRIMON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1832
Mailing Address - Country:US
Mailing Address - Phone:828-254-8889
Mailing Address - Fax:828-254-8887
Practice Address - Street 1:143 MERRIMON AVE STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1832
Practice Address - Country:US
Practice Address - Phone:828-254-8889
Practice Address - Fax:828-254-8887
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2504225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics