Provider Demographics
NPI:1023358157
Name:COLLIER, SHANNON (POSTPARTUM DOULA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:POSTPARTUM DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 QUINTANA PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1233
Mailing Address - Country:US
Mailing Address - Phone:202-573-1495
Mailing Address - Fax:
Practice Address - Street 1:609 QUINTANA PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1233
Practice Address - Country:US
Practice Address - Phone:202-573-1495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC4350374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula