Individual
KHALIAH LABELLE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4656 MIDWAY AVE, DAYTON, OH 45417-1354
(937) 856-3831
Mailing address
4656 MIDWAY AVE, DAYTON, OH 45417-1354
(937) 856-3831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0486045
—
OH
Enumeration date
06/16/2022
Last updated
06/16/2022
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