Individual
TITO JESUS COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 995-3499
(402) 599-2117
Mailing address
1510 LURTING AVE, BRONX, NY 10461-2411
(917) 620-5706
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
102684
NY
104100000X
Social Worker
44SL06293800
NJ
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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