MEDICARE: TERESA RAPER COLLINS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	510	NC

General Provider Information

NPI Number	:	1235301227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA RAPER COLLINS LPC

Provider Business Mailing Address
First Line	:	PO BOX 813
Second Line	:
City	:	LOWELL
State	:	NC
Zip	:	28098-0813
Country	:	US
Telephone Number	:	704-855-4411
Fax Number	:

Provider Business Practice Location Address
First Line	:	2012 ALTON CT
Second Line	:
City	:	LOWELL
State	:	NC
Zip	:	28098-2205
Country	:	US
Telephone Number	:	704-824-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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