MEDICARE: LATONJA COLLIER DSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		IN

General Provider Information

NPI Number	:	1508704024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONJA COLLIER DSP

Provider Business Mailing Address
First Line	:	800 N CAPITOL AVE APT 233
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1169
Country	:	US
Telephone Number	:	317-372-3858
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N CAPITOL AVE APT 233
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1169
Country	:	US
Telephone Number	:	317-372-3858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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Directions to “ LATONJA COLLIER DSP” Practice Location

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