Individual
MR. ROOSEVELT COLLINS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
141 EAST MAIN ST., WATERBURY, CT 06702-1701
(203) 574-9000
(203) 574-9006
Mailing address
141 E MAIN ST, UITE 402, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
CT
Other
Enumeration date
03/21/2012
Last updated
09/03/2013
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