Healthcare Provider Details

I. General information

NPI: 1831555176
Provider Name (Legal Business Name): EMMA COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMA PORTWOOD

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N MOUNT JULIET RD STE 118
MOUNT JULIET TN
37122-3786
US

IV. Provider business mailing address

1309 CASON TRL
MURFREESBORO TN
37128-6749
US

V. Phone/Fax

Practice location:
  • Phone: 615-200-8477
  • Fax:
Mailing address:
  • Phone: 615-545-3428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6468
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: