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General NPI Number Information
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NPI Number | 1003705039
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Entity Type | Individual
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Provider Name | AMANDA LYNNE COLLINS BS, MS, MA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1190 WINTERSON RD STE 160
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City | LINTHICUM
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State | MD
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Zip | 21090-2245
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Country | US
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Telephone | 410-684-3806
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Fax | 410-684-3973
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Provider Business Mailing Address
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Address Line | 450 TRIMBLEFIELDS DR
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City | EDGEWOOD
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State | MD
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Zip | 21040-3110
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Country | US
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Telephone | 410-688-5739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | A01079
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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