Provider Demographics
NPI:1801502182
Name:COLLIER, LISA CATHERINE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CATHERINE
Last Name:COLLIER
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 1:633 MARSHALL RD SW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6464
Mailing Address - Country:US
Mailing Address - Phone:703-868-3279
Mailing Address - Fax:
Practice Address - Street 1:633 MARSHALL RD SW
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-6464
Practice Address - Country:US
Practice Address - Phone:703-868-3279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program