Individual
TARA COLLINS SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D, LCP
Contact information
Practice address
3362 S 3RD ST, MEMPHIS, TN 38109-2944
(901) 701-2510
Mailing address
100 CAMPUS VIEW DR, LINCOLN, IL 62656-2111
(678) 643-9371
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
07100827
IL
103TC0700X
Clinical Psychologist
Primary
3472
TN
Other
Enumeration date
10/21/2006
Last updated
07/21/2022
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