Provider Demographics
NPI:1215914726
Name:COLLINS, TERRY LYNN (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:LYNN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1918 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307
Mailing Address - Country:US
Mailing Address - Phone:703-765-6819
Mailing Address - Fax:
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:STE 300 THE CHESAPEAKE CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150
Practice Address - Country:US
Practice Address - Phone:703-924-4185
Practice Address - Fax:703-922-0638
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist