MEDICARE: JOY COLLINS LMFT, RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	231	AK

General Provider Information

NPI Number	:	1760539225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY COLLINS LMFT, RPT

Provider Business Mailing Address
First Line	:	4325 LAUREL ST STE 297
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5338
Country	:	US
Telephone Number	:	907-569-5111
Fax Number	:	907-569-5112

Provider Business Practice Location Address
First Line	:	4532 LAUREL STREET, SUITE 297
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5338
Country	:	US
Telephone Number	:	907-569-5111
Fax Number	:	907-569-5112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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