Individual
MARIAH COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2291 W MARCH LN STE B103, STOCKTON, CA 95207-6652
(209) 981-5290
Mailing address
2291 W MARCH LN STE B103, STOCKTON, CA 95207-6652
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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