Provider Demographics
NPI:1306675608
Name:COLLINS, JAYLA DESHAY
Entity type:Individual
Prefix:MISS
First Name:JAYLA
Middle Name:DESHAY
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 1:205 HONDA CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5910
Mailing Address - Country:US
Mailing Address - Phone:470-894-5465
Mailing Address - Fax:
Practice Address - Street 1:205 HONDA CT
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5910
Practice Address - Country:US
Practice Address - Phone:470-894-5465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician