Individual
MARIETTA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH. D.
Contact information
Practice address
455 LEE STREET SW, 2ND FLOOR, ATLANTA, GA 30310
(404) 752-1000
Mailing address
720 WESTVIEW DRIVE SW, HARRIS BLDG., 100-A, ATLANTA, GA 30310-0000
(404) 756-1400
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002127
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007744331A
—
GA
Enumeration date
12/11/2006
Last updated
06/23/2021
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