Healthcare Provider Details

I. General information

NPI: 1295476315
Provider Name (Legal Business Name): ARIAL RENEE COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9180 W FLORISSANT AVE
SAINT LOUIS MO
63136-1421
US

IV. Provider business mailing address

1430 WASHINGTON AVE STE 229
SAINT LOUIS MO
63103-2029
US

V. Phone/Fax

Practice location:
  • Phone: 314-372-3420
  • Fax: 314-372-3415
Mailing address:
  • Phone: 314-970-5755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-334586
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: