Provider Demographics
NPI:1497512172
Name:COLLINS, TRISTIN
Entity Type:Individual
Prefix:
First Name:TRISTIN
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 ELDORADO PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-7438
Mailing Address - Country:US
Mailing Address - Phone:214-778-1153
Mailing Address - Fax:214-778-1153
Practice Address - Street 1:2831 ELDORADO PKWY STE 106
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-7438
Practice Address - Country:US
Practice Address - Phone:214-778-1153
Practice Address - Fax:214-778-1153
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician