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General NPI Number Information
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NPI Number | 1285970715
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Entity Type | Organization
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Legal Business Name | REGINA COLLINS COUNSELING, PLLC
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 9675 MAIN ST STE B
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City | FAIRFAX
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State | VA
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Zip | 22031-3762
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Country | US
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Telephone | 703-852-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 5872 LANGTON DR
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City | ALEXANDRIA
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State | VA
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Zip | 22310-1752
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Country | US
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Telephone | 301-221-5145
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINA DIANA COLLINS
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Credential | MA
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Telephone | 301-221-5145
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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 | 0701005325
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License Number State | VA
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