Provider Demographics
NPI:1093133068
Name:COLLINS, CIARA
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 BOLTON RD
Mailing Address - Street 2:UNIT 1117
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-1117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:843 BOLTON RD
Practice Address - Street 2:UNIT 1117
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-9020
Practice Address - Country:US
Practice Address - Phone:860-486-3692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist