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General NPI Number Information
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NPI Number | 1245005230
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Entity Type | Individual
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Provider Name | STEPHANIE JANE COLLINS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 5510 MATLOCK RD
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City | ARLINGTON
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State | TX
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Zip | 76018-1533
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Country | US
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Telephone | 817-704-6991
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Fax |
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Provider Business Mailing Address
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Address Line | 118 FAIRWEATHER DR
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City | BURLESON
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State | TX
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Zip | 76028-2192
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Country | US
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Telephone | 816-255-9492
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 91053
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License Number State | TX
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