Healthcare Provider Details

I. General information

NPI: 1467134999
Provider Name (Legal Business Name): ESTHER COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 JESSE CT
MONTVILLE NJ
07045-9022
US

IV. Provider business mailing address

400 FAIRFIELD RD UNIT 11263
FAIRFIELD NJ
07004-1945
US

V. Phone/Fax

Practice location:
  • Phone: 412-759-9285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberC62772390058022
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: