Individual
ALISA RENEE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005
(513) 649-8008
(513) 649-8004
Mailing address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1802332
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
ODADAS
OH
01
—
0074946
ODMH
OH
01
—
01-0693
CARF
OH
01
—
H130910
PTAN GROUP
OH
Enumeration date
11/07/2017
Last updated
06/16/2018
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