Individual
IESHA COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
17160 130TH AVE, NUNICA, MI 49448-9450
(616) 847-4460
Mailing address
320 MONROE AVE, MUSKEGON, MI 49441-2052
(231) 557-1833
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6361005570
MI
103TC1900X
Counseling Psychologist
Primary
6301013775
MI
Other
Enumeration date
08/28/2018
Last updated
12/16/2020
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