Individual
COLLIN SPECIALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6115 MOUNTAIN VILLA CV, AUSTIN, TX 78731-3518
(325) 450-3014
Mailing address
6115 MOUNTAIN VILLA CV, AUSTIN, TX 78731-3518
(325) 450-3014
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12614
TX
101YM0800X
Mental Health Counselor
Primary
73949
TX
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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