MEDICARE: KIARA COLLINS

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1568103737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA COLLINS

Provider Business Mailing Address
First Line	:	9180 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-1421
Country	:	US
Telephone Number	:	314-364-3662
Fax Number	:

Provider Business Practice Location Address
First Line	:	9180 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-1421
Country	:	US
Telephone Number	:	314-364-3662
Fax Number	:

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

Provider Enumeration Date	:	04/04/2022
Last Update Date	:	04/04/2022

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Directions to “ KIARA COLLINS ” Practice Location

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