Basic Information
| Provider Information | |||||||||
| NPI: | 1528461944 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLIER | ||||||||
| FirstName: | CHERI | ||||||||
| MiddleName: | LYN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, RD, LD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 S. GREEN ROAD SUITE #100 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910800 | ||||||||
| FaxNumber: | 2165900320 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 S. GREEN ROAD SUITE #100 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910800 | ||||||||
| FaxNumber: | 2165910320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2014 | ||||||||
| LastUpdateDate: | 09/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 4665 | OH | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.