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Individual
MR. EMIL JAY KOLICK VIII
Active
Individual
MR. EMIL JAY KOLICK VIII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
I0147
PA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4498
PA
101YA0400X
Addiction (Substance Use Disorder) Counselor
4759
PA
101YA0400X
Addiction (Substance Use Disorder) Counselor
FAC-K1308300929
NULL
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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