Healthcare Provider Details

I. General information

NPI: 1740282458
Provider Name (Legal Business Name): DEBORAH ANN COLLINS APRN, NP-C, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 MILITARY TRL STE 142
JUPITER FL
33458-6325
US

IV. Provider business mailing address

12300 HIGHWAY A1A ALT SUITE 112
PALM BEACH GARDENS FL
33410-2205
US

V. Phone/Fax

Practice location:
  • Phone: 561-480-8820
  • Fax: 561-242-1726
Mailing address:
  • Phone: 561-803-7600
  • Fax: 561-803-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2961972
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-54618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: