Most Relevant Information
Provider Data
| NPI Number: | 1003312703 |
| Provider Name: | JESSE DANIEL COLLINS PHD, LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH10669 |
Most Important Dates
| Enumeration Date: | 04/02/2018 |
| Last Updated: | 04/02/2018 |
Provider Practice Location
15310 AMBERLY DR STE 250
TAMPA
FL
336471642
Practice Location Phone/Fax
| Phone: | 8133766234 |
| Fax: |
Provider Mailing Location
5154 ROYAL CYPRESS CIR
TAMPA
FL
336475052
Provider Mailing Phone/Fax
| Phone: | 8133766234 |
| Fax: |