Provider Demographics
NPI:1649925439
Name:COLLINS, CHLOE JANAE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:JANAE
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 1:21612 LIBERTY ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-1362
Mailing Address - Country:US
Mailing Address - Phone:240-309-3697
Mailing Address - Fax:
Practice Address - Street 1:21612 LIBERTY ST UNIT 102
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1362
Practice Address - Country:US
Practice Address - Phone:240-309-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other