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Organization
MR AND MS MENTORING INC
Active
Organization
MR AND MS MENTORING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK TARIQ COLLINS EL M.S.W (OWNER)
(386) 262-9852
Entity
Organization
Contact information
Practice address
1615 RIDGEWOOD AVE, HOLLY HILL, FL 32117-1798
(386) 999-0333
Mailing address
19 STARLING DR, DAYTONA BEACH, FL 32117-1886
(386) 262-9852
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
05/12/2022
Last updated
08/12/2024
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