Provider Demographics
NPI:1205187101
Name:PEREZ-COLLIER, DOLORES M (CNA)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:M
Last Name:PEREZ-COLLIER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9585 POPLAR CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1798
Mailing Address - Country:US
Mailing Address - Phone:404-838-9768
Mailing Address - Fax:770-577-3640
Practice Address - Street 1:9585 POPLAR CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1798
Practice Address - Country:US
Practice Address - Phone:404-838-9768
Practice Address - Fax:770-577-3640
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHCP003622372600000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion