Individual
MARK COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LSW
Contact information
Practice address
221 E KIRKWOOD AVE, SUITE 5, BLOOMINGTON, IN 47408-3559
(917) 471-1784
Mailing address
221 E KIRKWOOD AVE, SUITE 5, BLOOMINGTON, IN 47408-3559
(917) 471-1784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33007901A
IN
Other
Enumeration date
03/17/2017
Last updated
03/17/2017
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