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General NPI Number Information
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NPI Number | 1841599552
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Entity Type | Individual
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Provider Name | SHAUNTE' A COLLINS L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 1422 W MAIN ST SUITE 205
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City | LEWISVILLE
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State | TX
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Zip | 75067-3388
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Country | US
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Telephone | 469-549-4200
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Fax | 469-549-4201
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Provider Business Mailing Address
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Address Line | 18240 MIDWAY RD APT 1706
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City | DALLAS
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State | TX
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Zip | 75287-4923
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Country | US
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Telephone | 972-743-9584
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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 | 64356
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License Number State | TX
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