Individual
MS. CARRIE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS SLP
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Mailing address
SIH PO BOX 3988, CARBONDALE, IL 62902
(618) 942-2171
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.000738
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005830
—
IL
Enumeration date
09/29/2008
Last updated
02/16/2010
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