Provider Demographics
NPI:1588070171
Name:COLLIER, CYNTHIA (AUD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1455 E BERT KOUNS INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-6000
Mailing Address - Country:US
Mailing Address - Phone:318-798-4500
Mailing Address - Fax:
Practice Address - Street 1:1455 E BERT KOUNS INDUSTRIAL LOOP STE 206
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5634
Practice Address - Country:US
Practice Address - Phone:318-798-4442
Practice Address - Fax:318-798-4529
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80599231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80599OtherAUDIOLOGY LICENSE