Collis, Angelique Dawn
Collis, Angelique Dawn is an individual health care provider with primary practice located at 901 Ne Independence Ave , Lees Summit MO 64086-5544. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Collis, Angelique Dawn can be contacted via phone (816) 347-3232.Contact Information
Primary practice address
901 Ne Independence Ave
Lees Summit MO 64086-5544
Phone: (816) 347-3232
Fax: (816) 246-8207
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2001028089 | Missouri |
Profile Details
| NPI number | 1306044532 |
|---|---|
| LBN Legal business name | Collis, Angelique Dawn |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | Nov 20th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306044532 | NPPES |
| Missouri | Other | 307F576C | MEDICARE PERF. PROV. # |
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