Provider Demographics
NPI:1760135131
Name:COLLINS, RONALD JAMES (RADT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAMES
Last Name:COLLINS
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20421 HARBOR ISLE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5207
Mailing Address - Country:US
Mailing Address - Phone:626-219-5269
Mailing Address - Fax:
Practice Address - Street 1:1501 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-7723
Practice Address - Country:US
Practice Address - Phone:626-219-5269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)