Provider Demographics
NPI:1669796934
Name:COLLINS, ANTHONY TYRONE (CBHT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:TYRONE
Last Name:COLLINS
Suffix:
Gender:M
Credentials:CBHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 NW 29TH TER
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-2806
Mailing Address - Country:US
Mailing Address - Phone:954-226-8944
Mailing Address - Fax:
Practice Address - Street 1:3042 NW 29TH TER
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-2806
Practice Address - Country:US
Practice Address - Phone:954-226-8944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health