Individual
MISS CARLA SUE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 VETERANS DRIVE, P.O. BOX 869, HARRISBURG, IL 62946-6294
(618) 252-0377
(618) 252-2389
Mailing address
511 S GRAHAM AVE APT 310, CARBONDALE, IL 62901-3377
(618) 262-6283
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/05/2017
Last updated
09/14/2021
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