Provider Demographics
NPI:1942853486
Name:COLLINS, JAMIAMMMIE COLLINS
Entity Type:Individual
Prefix:
First Name:JAMIAMMMIE
Middle Name:COLLINS
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 SW 33RD DR
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5503
Mailing Address - Country:US
Mailing Address - Phone:786-768-4394
Mailing Address - Fax:
Practice Address - Street 1:4541 SW 33RD DR
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5503
Practice Address - Country:US
Practice Address - Phone:786-768-4394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3509104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker