Healthcare Provider Details

I. General information

NPI: 1578007530
Provider Name (Legal Business Name): ALANNA COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2016
Last Update Date: 12/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 ALLEGHENY AVE
TOWSON MD
21204-3909
US

IV. Provider business mailing address

5725 PIMLICO RD
BALTIMORE MD
21209-4315
US

V. Phone/Fax

Practice location:
  • Phone: 609-947-0377
  • Fax:
Mailing address:
  • Phone: 609-947-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR203614
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: