Provider Demographics
NPI:1790066710
Name:COLLINS, TERESA FERNANDES (MED)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:FERNANDES
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROCKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1664
Mailing Address - Country:US
Mailing Address - Phone:814-330-8651
Mailing Address - Fax:
Practice Address - Street 1:1 ROCKVIEW PL
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1664
Practice Address - Country:US
Practice Address - Phone:814-330-8651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-03
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor