Doctor Name: | MICHAL ANGELIQUE COLLIER |
NPI Number: | 1083002620 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 231778 |
Business Practice Address: | 4246 Mountain Glen Trce Snellville, GA - 300396475 |
Business Phone Number: | 4045939921 |
Business Fax Number: | 4045968583 |
Mailing Address: | Po Box 371218, DECATUR |
State: | GA |
Postal Code: | 300371218 |
Phone Number: | 4045939921 |
Fax Number: | 4045968583 |
NPI Enumeration Date: | 01/06/2015 |
NPI Last Update Date: | 01/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 231778 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |