| NPI | 1972988020 |
|---|---|
| Former Name | MARY FAYE COLLINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006368) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133001567) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2020-08-05 |