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General NPI Number Information
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NPI Number | 1063838423
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Entity Type | Individual
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Provider Name | MOLLY COLLINS
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Gender | Female
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 23079 CREST FOREST DRIVE
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City | CRESTLINE
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State | CA
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Zip | 92325
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Country | US
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Telephone | 909-436-8461
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4763
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City | CRESTLINE
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State | CA
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Zip | 92325-4763
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Country | US
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Telephone |
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2278E0002X
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Taxonomy Name | Emergency Care Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2278G0305X
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Taxonomy Name | Geriatric Care Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2278G1100X
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Taxonomy Name | General Care Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number | 30048
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License Number State | CA
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