Healthcare Provider Details

I. General information

NPI: 1619283488
Provider Name (Legal Business Name): LAUREN J COLLIER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 50TH ST
LUBBOCK TX
79412-2565
US

IV. Provider business mailing address

2345 50TH ST
LUBBOCK TX
79412-2565
US

V. Phone/Fax

Practice location:
  • Phone: 806-780-8300
  • Fax: 806-780-8383
Mailing address:
  • Phone: 806-780-8300
  • Fax: 806-780-8383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number64603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: