Provider Demographics
NPI:1386465433
Name:COLYNS, KEVIN DEVON
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DEVON
Last Name:COLYNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 SWALLOW CREST DR APT H
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1709
Mailing Address - Country:US
Mailing Address - Phone:410-568-5787
Mailing Address - Fax:
Practice Address - Street 1:8098 SANDPIPER CIR
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4974
Practice Address - Country:US
Practice Address - Phone:410-205-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst