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Individual

MS. SALLY JANE COLLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT, MA, ATR

Contact information

Practice address
190 N 10TH ST, SUITE 301, BROOKLYN, NY 11211-9325
(917) 861-7496
Mailing address
85 CHRISTOPHER STREET,, APT. 3A, NEW YORK, NY 10014
(917) 861-7496

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000853
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000853
MARRIAGE AND FAMILY THERAPY LICENSE ID NUMBER
NY
Enumeration date
02/25/2011
Last updated
02/25/2011
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