Individual
JESSICA ROSE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. LMHC, LSAA
Contact information
Practice address
4100 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 702-8547
Mailing address
923 COUNTRY CLUB DR SE APT H, RIO RANCHO, NM 87124-2286
(505) 410-4328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0145091
NM
101YM0800X
Mental Health Counselor
Primary
0182541
NM
Other
Enumeration date
08/04/2011
Last updated
07/22/2016
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