| Doctor Name: | MS. DEBORA MARIE COLLINS |
| NPI Number: | 1053677369 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 6301014342 |
| Business Practice Address: | 13101 Allen Rd Southgate, MI - 481952216 |
| Business Phone Number: | 7347857700 |
| Business Fax Number: | |
| Mailing Address: | 5458 Martin St, DETROIT |
| State: | MI |
| Postal Code: | 482102330 |
| Phone Number: | 3137375704 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2012 |
| NPI Last Update Date: | 04/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301014342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |