Healthcare Provider Details

I. General information

NPI: 1083357388
Provider Name (Legal Business Name): MR. MARK REY COLLINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARKIZ REY

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

15004 GREEN WING TER
UPPER MARLBORO MD
20774-7060
US

V. Phone/Fax

Practice location:
  • Phone: 301-267-7201
  • Fax:
Mailing address:
  • Phone: 301-267-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: