Provider Demographics
NPI:1801045968
Name:COLLIER, THERESA L (ND)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:L
Last Name:COLLIER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 W VILLAGE GREEN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4876
Mailing Address - Country:US
Mailing Address - Phone:804-744-4927
Mailing Address - Fax:
Practice Address - Street 1:5102 W VILLAGE GREEN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4876
Practice Address - Country:US
Practice Address - Phone:804-744-4927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT0990000132175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath