Provider Demographics
NPI:1245524644
Name:COLLIER, MEGHAN L (PHD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:L
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:L
Other - Last Name:KEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1275 WAMPANOAG TRL STE 9
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1217
Mailing Address - Country:US
Mailing Address - Phone:401-352-8440
Mailing Address - Fax:
Practice Address - Street 1:1275 WAMPANOAG TRL STE 9
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1217
Practice Address - Country:US
Practice Address - Phone:401-352-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2025-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01673103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265EMedicaid