Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4639 | MD |
NPI | 1003224494 |
---|---|
Provider Name | Dr. Noah Collins |
First Address | College Park, MD 20742-0001 |
Second Address | College Park, MD 20742-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 29/07/2014 |