Individual
JASON COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SSP
Contact information
Practice address
719 S FOREST PARK DR, EUREKA, IL 61530-1513
(309) 258-7607
Mailing address
719 S FOREST PARK DR, EUREKA, IL 61530-1513
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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