Provider Demographics
NPI:1508350752
Name:COLLINS, HELENA M
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13290 NOEL RD APT 339
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5661
Mailing Address - Country:US
Mailing Address - Phone:832-602-7572
Mailing Address - Fax:
Practice Address - Street 1:4516 BOAT CLUB RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-7019
Practice Address - Country:US
Practice Address - Phone:817-238-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool