Provider Demographics
NPI:1891529095
Name:COLLINS, KWANA N
Entity type:Individual
Prefix:MRS
First Name:KWANA
Middle Name:N
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 1:30 FARLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4420
Mailing Address - Country:US
Mailing Address - Phone:302-545-3938
Mailing Address - Fax:
Practice Address - Street 1:30 FARLEIGH DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-4420
Practice Address - Country:US
Practice Address - Phone:302-545-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health