Doctor Name: | LILLIAN COLLINS |
NPI Number: | 1114229184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCDC |
License Number: | 9602 |
Business Practice Address: | 619 N Main St Cleburne, TX - 760333843 |
Business Phone Number: | 8175588807 |
Business Fax Number: | 8175586919 |
Mailing Address: | 619 N Main St, CLEBURNE |
State: | TX |
Postal Code: | 760333843 |
Phone Number: | 8175588807 |
Fax Number: | 8175586919 |
NPI Enumeration Date: | 11/24/2010 |
NPI Last Update Date: | 11/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 9602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |