Provider Demographics
NPI:1326397456
Name:COLLINS, JEANNETTE MARIE (PT)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:JEANNETTE
Other - Middle Name:MARIE
Other - Last Name:COUTURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,ATC
Mailing Address - Street 1:3 CROSSCUT CT
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9336
Mailing Address - Country:US
Mailing Address - Phone:646-734-0529
Mailing Address - Fax:
Practice Address - Street 1:3 CROSSCUT CT
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9336
Practice Address - Country:US
Practice Address - Phone:646-734-0529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034652-1225100000X
FL41516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist