Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | IL |
NPI | 1053429647 |
---|---|
Provider Name | Dr. Dawn M Collins |
First Address | Evanston, IL 60201-3156 |
Second Address | Evanston, IL 60201-3156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |