Provider Demographics
NPI:1457198939
Name:COLLINS, DANIELLE NEW
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NEW
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 1:702 W MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-4122
Mailing Address - Country:US
Mailing Address - Phone:678-332-7955
Mailing Address - Fax:678-719-7540
Practice Address - Street 1:702 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-4122
Practice Address - Country:US
Practice Address - Phone:678-332-7955
Practice Address - Fax:678-719-7540
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health