Provider Demographics
NPI:1235849498
Name:COLLET, CHRISTINA ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:COLLET
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 1:1181 FAGINS RUN RD
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-9183
Mailing Address - Country:US
Mailing Address - Phone:513-673-8115
Mailing Address - Fax:513-721-8819
Practice Address - Street 1:1181 FAGINS RUN RD
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:45157-9183
Practice Address - Country:US
Practice Address - Phone:513-673-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion