Individual
MR. COLLIS ENGLENT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S
Contact information
Practice address
1200 CONCORD AVE STE 100, CONCORD, CA 94520-4969
(510) 268-8120
(323) 866-1881
Mailing address
10390 COLOMA RD STE A, RANCHO CORDOVA, CA 95670-2152
(877) 910-6538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73911
CA
Other
Enumeration date
03/24/2021
Last updated
07/12/2024
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