Individual
TAL COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 704-1924
Mailing address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/14/2019
Last updated
04/29/2024
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