Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 10130 | MA |
Y | 103T00000X | Psychologist | 10130 | MA |
N | 1041C0700X | Clinical Social Worker |
NPI | 1013283704 |
---|---|
Provider Name | Christi Collins |
First Address | Brookline, MA 02445-6853 |
Second Address | Brookline, MA 02445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 04/06/2018 |