Provider Demographics
NPI:1326105321
Name:COLLIER, SAMUEL DOUGLAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DOUGLAS
Last Name:COLLIER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 LOMAC ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2817
Mailing Address - Country:US
Mailing Address - Phone:334-244-2100
Mailing Address - Fax:334-244-2100
Practice Address - Street 1:4216 LOMAC ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2817
Practice Address - Country:US
Practice Address - Phone:334-244-2100
Practice Address - Fax:334-244-2100
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist