Individual
MR. ISAAC WILSON COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
131 W BROAD ST, ROCHESTER, NY 14614-1103
(585) 262-8100
Mailing address
128 JACKSON ST, ROCHESTER, NY 14621-4020
(585) 414-6264
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
086816
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086816
NEW YORK STATE EDUCATION DEPARTMENT
NY
Enumeration date
09/02/2012
Last updated
09/02/2012
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