Provider Demographics
NPI:1952991663
Name:COLLIER, DONESHA
Entity Type:Individual
Prefix:
First Name:DONESHA
Middle Name:
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 1:542 S DEARBORN ST STE 580
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1573
Mailing Address - Country:US
Mailing Address - Phone:708-942-1716
Mailing Address - Fax:708-320-8917
Practice Address - Street 1:542 S DEARBORN ST STE 580
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1573
Practice Address - Country:US
Practice Address - Phone:708-942-1716
Practice Address - Fax:708-320-8917
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist