Individual
MS. ILENE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 CHERRY LN STE 201, MANTECA, CA 95337-4311
(209) 478-9862
Mailing address
302 CHERRY LN STE 201, MANTECA, CA 95337-4311
(646) 241-8841
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
172V00000X
Community Health Worker
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
11/30/2017
Last updated
05/10/2024
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