Individual
MYRTLE L COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32175 E 723 RD, WAGONER, OK 74467-7425
(918) 485-1552
Mailing address
32175 E 723 RD, WAGONER, OK 74467-7425
(918) 485-1552
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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