Individual
MARA BLYTHE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1189 EUCLID AVE NE, ATLANTA, GA 30307-1509
(404) 522-9912
Mailing address
2937 KIMMERIDGE DR, ATLANTA, GA 30344-6809
(678) 938-7677
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001258
GA
Other
Enumeration date
09/06/2012
Last updated
07/10/2014
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