Provider Demographics
NPI:1689490765
Name:RAJOTTE, COLLEEN (OTR/L)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:RAJOTTE
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 1:3016 ESTATE ORANGE GRV
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4595
Mailing Address - Country:US
Mailing Address - Phone:781-742-5082
Mailing Address - Fax:
Practice Address - Street 1:3016 ESTATE ORANGE GRV
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4595
Practice Address - Country:US
Practice Address - Phone:340-473-5924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA486747225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist