Doctor Name: | MRS. PHYLLIS LYNNE COLAGROSS |
NPI Number: | 1518263276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801089631 |
Business Practice Address: | 177 N Barlow Rd Harrisville, MI - 487409607 |
Business Phone Number: | 9897368157 |
Business Fax Number: | 9893583762 |
Mailing Address: | 177 N Barlow Rd, Po Box 279 HARRISVILLE |
State: | MI |
Postal Code: | 487409607 |
Phone Number: | 9897368157 |
Fax Number: | 9893583762 |
NPI Enumeration Date: | 01/28/2011 |
NPI Last Update Date: | 07/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801089631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |