Healthcare Provider Details

I. General information

NPI: 1821208042
Provider Name (Legal Business Name): CATHERINE MARIE COLLINS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 COUNTRY VILLAGE DR SUITE 102
CORDOVA TN
38016-2029
US

IV. Provider business mailing address

8134 COUNTRY VILLAGE DR SUITE 102
CORDOVA TN
38016-2029
US

V. Phone/Fax

Practice location:
  • Phone: 901-756-8398
  • Fax: 901-756-8701
Mailing address:
  • Phone: 901-756-8398
  • Fax: 901-756-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP1200
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: