Provider Demographics
NPI:1215297098
Name:MULLERY-FRANCHELLA, COLLEEN ANN (OT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ANN
Last Name:MULLERY-FRANCHELLA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2065
Mailing Address - Country:US
Mailing Address - Phone:570-628-6950
Mailing Address - Fax:570-628-6953
Practice Address - Street 1:149 S HUNTER HWY
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2422
Practice Address - Country:US
Practice Address - Phone:570-788-7555
Practice Address - Fax:570-788-7640
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002884L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist