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Individual

MARK COLLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MHA

Contact information

Practice address
300 FOXGLOVE DR, MT STERLING, KY 40353-9769
(859) 498-2135
(859) 498-7547
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
UNLICENSED

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30610026
KY
Enumeration date
07/08/2014
Last updated
11/06/2014
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