Individual
SUSAN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1409 DEVINE ST, COLUMBIA, SC 29208-3902
(803) 777-5223
Mailing address
PO BOX 620, GILBERT, SC 29054-0620
(803) 530-5093
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1399
SC
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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