Individual
MR. KOLY J. GUILAVOGUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
770 E 176TH ST STE 315, BRONX, NY 10460-4617
(718) 583-5150
(718) 228-7648
Mailing address
770 E 176TH ST, BRONX, NY 10460-4617
(718) 583-5150
(718) 228-7648
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31698-T
NY
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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