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General NPI Number Information
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NPI Number | 1598427072
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Entity Type | Individual
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Provider Name | JOHN KEVIN COLLIER JR. LMSW
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Gender | Male
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 208 E MAIN ST UNIT B
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City | SALISBURY
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State | MD
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Zip | 21801-4923
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Country | US
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Telephone | 443-234-0204
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Fax |
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Provider Business Mailing Address
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Address Line | 30026 STONEYBROOKE DR
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City | SALISBURY
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State | MD
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Zip | 21804-2481
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Country | US
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Telephone | 443-614-8385
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 24421
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License Number State | MD
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