Provider Demographics
NPI:1134512080
Name:COLLINS, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
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 1:4358 AIRPARK DR
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:MI
Mailing Address - Zip Code:48658-9447
Mailing Address - Country:US
Mailing Address - Phone:989-846-4441
Mailing Address - Fax:989-846-2137
Practice Address - Street 1:4358 AIRPARK DR
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-9447
Practice Address - Country:US
Practice Address - Phone:989-846-4441
Practice Address - Fax:989-846-2137
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services