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General NPI Number Information
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NPI Number | 1942032487
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Entity Type | Individual
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Provider Name | MARISSA COLLING LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 23332 ORCHARD LAKE RD STE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-3280
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Country | US
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Telephone | 586-310-8158
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Fax |
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Provider Business Mailing Address
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Address Line | 32222 MARYLAND ST
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City | LIVONIA
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State | MI
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Zip | 48150-3814
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Country | US
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Telephone | 734-895-5883
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801099341
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License Number State | MI
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