Provider Demographics
NPI:1538224795
Name:COLLING, RENA M (AUD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:M
Last Name:COLLING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 WOLF RIVER CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1750
Mailing Address - Country:US
Mailing Address - Phone:901-682-1529
Mailing Address - Fax:
Practice Address - Street 1:7675 WOLF RIVER CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1750
Practice Address - Country:US
Practice Address - Phone:901-682-1529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001049231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1538224795Medicaid
TNQ035013Medicaid