MEDICARE: DR. VIRGINIA B COLLINGS PHD

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	103TC0700X	Clinical Psychologist	3441	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942239066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGINIA B COLLINGS PHD

Provider Business Mailing Address
First Line	:	18660 BAGLEY RD
Second Line	:	SUITE 205
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3483
Country	:	US
Telephone Number	:	440-234-8338
Fax Number	:

Provider Business Practice Location Address
First Line	:	18660 BAGLEY RD
Second Line	:	SUITE 205
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3483
Country	:	US
Telephone Number	:	440-234-8338
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/09/2007

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