Healthcare Provider Details

I. General information

NPI: 1831468289
Provider Name (Legal Business Name): GAIL COLLINS,MS,LPC,LMFT,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 SOUTHWEST FWY
SUGAR LAND TX
77478-3466
US

IV. Provider business mailing address

PO BOX 34
SUGAR LAND TX
77487-0034
US

V. Phone/Fax

Practice location:
  • Phone: 713-817-7035
  • Fax:
Mailing address:
  • Phone: 713-817-7035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61025
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number200936
License Number StateTX

VIII. Authorized Official

Name: PHYLLIS G. COLLINS
Title or Position: CONTACT PERSON
Credential:
Phone: 713-817-7035