Individual
MARK A COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
221 BEACH 80TH ST, APT 3C, ROCKAWAY BEACH, NY 11693-2002
(718) 474-0539
Mailing address
221 BEACH 80TH ST, APT 3C, ROCKAWAY BEACH, NY 11693-2002
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101Y00000X
NY
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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