Individual
MRS. PATRICIA MARIE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-4000
(774) 826-3157
Mailing address
14 AMARK RD, BROCKTON, MA 02302-2149
(774) 826-2012
(774) 826-3157
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
1943
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1943
STATE LICENSE FOR RD
MA
01
—
435327
DIETETIC REGISTRATION
MA
Enumeration date
07/19/2006
Last updated
07/08/2007
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