Provider Demographics
NPI:1578084976
Name:COLLINS, DENISE
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:850 KALISTE SALOOM RD. STE #117
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7050
Mailing Address - Country:US
Mailing Address - Phone:337-234-7109
Mailing Address - Fax:337-234-7898
Practice Address - Street 1:2701 JOHNSTON ST STE 300
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3263
Practice Address - Country:US
Practice Address - Phone:337-446-4707
Practice Address - Fax:337-446-4715
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator