Provider Demographics
NPI:1174078505
Name:COLLIER-JONES, OLLIE
Entity type:Individual
Prefix:
First Name:OLLIE
Middle Name:
Last Name:COLLIER-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 ROSEMARY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 ROSEMARY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3768
Practice Address - Country:US
Practice Address - Phone:330-737-7121
Practice Address - Fax:234-334-1660
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI34161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1558805630Other1558805630