Provider Demographics
NPI:1982983995
Name:COLLINS, STEVEN LEE (MA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LEE
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-4260
Mailing Address - Country:US
Mailing Address - Phone:304-910-9345
Mailing Address - Fax:
Practice Address - Street 1:313 COURT HOUSE ROAD SUITE 2
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24739
Practice Address - Country:US
Practice Address - Phone:304-431-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist