Individual
JEFFERY S COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
917 W MAIN ST, SUITE 203, BRIDGEPORT, WV 26330-1650
(304) 842-7007
(304) 842-7099
Mailing address
917 W MAIN ST, SUITE 203, BRIDGEPORT, WV 26330-1650
(304) 842-7007
(304) 842-7099
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
909
WV
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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