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General NPI Number Information
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NPI Number | 1073370250
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Entity Type | Individual
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Provider Name | ASHEIKA DENAE COLLINS
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 2101 TOWER DR STE A
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City | MONROE
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State | LA
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Zip | 71201-5045
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Country | US
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Telephone | 318-570-5403
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Fax |
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Provider Business Mailing Address
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Address Line | 206 CURVE DR APT 77
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City | MONROE
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State | LA
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Zip | 71203-4253
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Country | US
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Telephone | 318-307-2741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PLPC10114
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License Number State | LA
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