Individual
MARK COLLINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 UNIVERSITY PKWY, AIKEN, SC 29801-6810
(803) 645-6911
Mailing address
1112 BLUE SPRUCE DR, GRANITEVILLE, SC 29829-3980
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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