Provider Demographics
NPI:1528697737
Name:KATELYN COLLINS, PLLC
Entity type:Organization
Organization Name:KATELYN COLLINS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-214-4266
Mailing Address - Street 1:4140 STATE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4025
Mailing Address - Country:US
Mailing Address - Phone:989-214-4266
Mailing Address - Fax:
Practice Address - Street 1:4140 STATE ST STE 300
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4025
Practice Address - Country:US
Practice Address - Phone:989-214-4266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty