| Doctor Name: | MS. JUDITH GLASS COLLINS |
| NPI Number: | 1114179462 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PY00003707 |
| Business Practice Address: | 20174 Front St Ne Poulsbo, WA - 983707445 |
| Business Phone Number: | 3606971141 |
| Business Fax Number: | 3606972395 |
| Mailing Address: | 415 Meade Rd, NORDLAND |
| State: | WA |
| Postal Code: | 983589618 |
| Phone Number: | 3603799448 |
| Fax Number: | 3603796882 |
| NPI Enumeration Date: | 10/17/2008 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |