Provider Demographics
NPI:1205332491
Name:COLLINS, PATRICIA DEANE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DEANE
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 1:607 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-1417
Mailing Address - Country:US
Mailing Address - Phone:816-633-5334
Mailing Address - Fax:
Practice Address - Street 1:607 S 3RD ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-1417
Practice Address - Country:US
Practice Address - Phone:816-633-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist