Provider Demographics
NPI:1871914051
Name:COLLIER, BRIAN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:COLLIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15936 W VOGEL AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-3569
Mailing Address - Country:US
Mailing Address - Phone:602-292-8102
Mailing Address - Fax:
Practice Address - Street 1:15936 W VOGEL AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-3569
Practice Address - Country:US
Practice Address - Phone:602-292-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-14
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor