Provider Demographics
NPI:1275682692
Name:COLLINS, DENA RENEE
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:RENEE
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 1:2001 OLD CONCORD RD SE
Mailing Address - Street 2:B-8
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-1141
Mailing Address - Country:US
Mailing Address - Phone:770-778-1461
Mailing Address - Fax:678-842-9715
Practice Address - Street 1:2001 OLD CONCORD RD SE
Practice Address - Street 2:B-8
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-1141
Practice Address - Country:US
Practice Address - Phone:770-778-1461
Practice Address - Fax:678-842-9715
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator