Provider Demographics
NPI:1205369543
Name:COLLIER, JUDITH ANN (BACHELORS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:COLLIER
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 512-39
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-526-8700
Mailing Address - Fax:501-526-8740
Practice Address - Street 1:410 CAMP RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-1487
Practice Address - Country:US
Practice Address - Phone:870-892-0027
Practice Address - Fax:870-892-7945
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist