Healthcare Provider Details

I. General information

NPI: 1245753953
Provider Name (Legal Business Name): BETTIN D COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 N. RAILROAD AVE.
ARCADIA LA
71001
US

IV. Provider business mailing address

1921 N RAILROAD AVE
ARCADIA LA
71001-3423
US

V. Phone/Fax

Practice location:
  • Phone: 318-579-5105
  • Fax:
Mailing address:
  • Phone: 13185795105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: