Doctor Name: | MRS. JENNIFER ANNE WALLACE COLLINS |
NPI Number: | 1497941066 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, ATR |
License Number: | |
Business Practice Address: | 804 Springwood Ln Lower Gwynedd, PA - 19002 |
Business Phone Number: | 8574980317 |
Business Fax Number: | |
Mailing Address: | 804 Springwood Ln, LOWER GWYNEDD |
State: | PA |
Postal Code: | 19002 |
Phone Number: | 8574980317 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2007 |
NPI Last Update Date: | 09/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |