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General NPI Number Information
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NPI Number | 1952138406
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Entity Type | Individual
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Provider Name | EMILY COLLIE
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Gender | Female
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 417 N BLOUNT ST STE 200
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City | RALEIGH
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State | NC
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Zip | 27601-1009
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Country | US
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Telephone | 919-249-8281
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Fax |
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Provider Business Mailing Address
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Address Line | 5727 MAGELLAN WAY APT 104
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City | RALEIGH
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State | NC
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Zip | 27612-2264
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Country | US
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Telephone | 804-929-2566
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20524
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License Number State | NC
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