MEDICARE: MYNIKA COLLINS

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	101YM0800X	Mental Health Counselor	82147	TX

General Provider Information

NPI Number	:	1861026684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYNIKA COLLINS

Provider Business Mailing Address
First Line	:	1638 W ALABAMA ST STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1638 W ALABAMA ST STE 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4102
Country	:	US
Telephone Number	:	832-387-5735
Fax Number	:

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

Provider Enumeration Date	:	03/02/2020
Last Update Date	:	03/02/2020

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Directions to “ MYNIKA COLLINS ” Practice Location

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