Doctor Name: | JASON COLLINS |
NPI Number: | 1700041183 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC/SLP-L |
License Number: | 012649 |
Business Practice Address: | 60 Charlestown Rd Amherst, NY - 142264606 |
Business Phone Number: | 7162287571 |
Business Fax Number: | 7168831482 |
Mailing Address: | 60 Charlestown Rd, AMHERST |
State: | NY |
Postal Code: | 142264606 |
Phone Number: | 7162287571 |
Fax Number: | 7168831482 |
NPI Enumeration Date: | 07/24/2008 |
NPI Last Update Date: | 11/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 012649 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |