Provider Demographics
NPI:1326435306
Name:COLLINS, DEANNA CHARICE X
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:CHARICE
Last Name:COLLINS
Suffix:X
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DEANNA
Other - Middle Name:CHARICE
Other - Last Name:COLLINS
Other - Suffix:X
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2919 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6913
Mailing Address - Country:US
Mailing Address - Phone:405-473-5946
Mailing Address - Fax:405-949-0929
Practice Address - Street 1:2808 NW 31ST ST
Practice Address - Street 2:2808 N.W. 31ST STREET
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7407
Practice Address - Country:US
Practice Address - Phone:405-848-7555
Practice Address - Fax:405-949-0929
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist