Individual
MARK THOMAS COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC, LADC
Contact information
Practice address
3675 IHDUHAPI RD, LORETTO, MN 55357-2120
(763) 479-3555
(763) 479-2605
Mailing address
PO BOX 308, LORETTO, MN 55357-0308
(763) 479-3555
(763) 479-2605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2762
MN
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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