Doctor Name: | JESSICA COLLINS |
NPI Number: | 1083059364 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY. D. |
License Number: | NOT LISCENSED |
Business Practice Address: | 127 S State St Newtown, PA - 189401956 |
Business Phone Number: | 2159685151 |
Business Fax Number: | |
Mailing Address: | 262 Hickory Rd, YARDLEY |
State: | PA |
Postal Code: | 190673409 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/01/2013 |
NPI Last Update Date: | 04/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | NOT LISCENSED |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |