Provider Demographics
NPI:1962243097
Name:COLLINS, AMBER MARIE (MA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10127 MOROCCO STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216
Mailing Address - Country:US
Mailing Address - Phone:210-838-5351
Mailing Address - Fax:210-800-9922
Practice Address - Street 1:10127 MOROCCO STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
Practice Address - Country:US
Practice Address - Phone:210-838-5351
Practice Address - Fax:210-800-9922
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71032103TS0200X
TX37887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool