Provider Demographics
NPI:1194433953
Name:COLLINS, BRITTANY MONA
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MONA
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 1:16845 HIGHLAND CLUB AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-7038
Mailing Address - Country:US
Mailing Address - Phone:225-229-1534
Mailing Address - Fax:
Practice Address - Street 1:16845 HIGHLAND CLUB AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-7038
Practice Address - Country:US
Practice Address - Phone:225-229-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16760104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker