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General NPI Number Information
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NPI Number | 1528853041
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Entity Type | Organization
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Legal Business Name | COLLIER THERAPY, LLC.
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 6700 W CENTRAL AVE STE 106
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City | WICHITA
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State | KS
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Zip | 67212-6302
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Country | US
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Telephone | 316-945-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 428 S STONEY POINT ST
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City | WICHITA
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State | KS
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Zip | 67209-3524
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Country | US
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Telephone | 229-630-1798
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Fax | 615-658-1388
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JERYN COLLIER
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Credential | LMFT
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Telephone | 229-630-1798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 |
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License Number State |
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