Provider Demographics
NPI:1689183451
Name:COLLIER, CHRISTINA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 PREMIER DRIVE
Mailing Address - Street 2:SUITE #234
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:940-300-7606
Mailing Address - Fax:469-374-0800
Practice Address - Street 1:1603 MEDICAL PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-528-5063
Practice Address - Fax:855-338-3248
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-17-27527103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-17-27527OtherBACB