Individual
JENICE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT SERVICE
Contact information
Practice address
423 EDDY RD, CLEVELAND, OH 44108-1754
(216) 848-9115
Mailing address
423 EDDY RD, CLEVELAND, OH 44108-1754
(216) 848-9115
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0405697
—
OH
Enumeration date
12/04/2016
Last updated
10/18/2023
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