Healthcare Provider Details

I. General information

NPI: 1952846230
Provider Name (Legal Business Name): ALYSSA COLLIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

20410 CENTURY BLVD SUITE 215
GERMANTOWN MD
20874-1186
US

V. Phone/Fax

Practice location:
  • Phone: 202-466-9719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: