Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 09425 | TX |
NPI | 1003128406 |
---|---|
Provider Name | Catherine Collier |
First Address | Fort Worth, TX 76107-4335 |
Second Address | Fort Worth, TX 76107-4335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2010 |
Last Update Date | 14/07/2010 |