Individual
MAGDA GISELLE COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CT
Contact information
Practice address
5209 DETROIT AVE, CLEVELAND, OH 44102-2224
(216) 815-1019
Mailing address
5700 VANDALIA AVE, CLEVELAND, OH 44144-3945
(216) 507-8045
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
C.2204434
OH
Other
Enumeration date
07/02/2021
Last updated
03/09/2023
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