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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306044532 NPPES
Missouri Other 307F576C MEDICARE PERF. PROV. #

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