Provider Demographics
NPI:1952827768
Name:COLLINS WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:COLLINS WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOLISTIC HEALTH ADVOCATE
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:CNHP, ND
Authorized Official - Phone:301-735-6747
Mailing Address - Street 1:2006 WHITTAKER CT
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2559
Mailing Address - Country:US
Mailing Address - Phone:301-735-6747
Mailing Address - Fax:
Practice Address - Street 1:2006 WHITTAKER CT
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2559
Practice Address - Country:US
Practice Address - Phone:301-735-6747
Practice Address - Fax:301-735-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty