Individual
WALLY KOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1326 CHESTNUT ST, PHILADELPHIA, PA 19107-4525
(215) 650-8231
Mailing address
1326 CHESTNUT ST, PHILADELPHIA, PA 19107-4525
(215) 650-8231
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH007492
PA
106S00000X
Behavior Technician
Primary
RBT-18-56098
—
Other
Enumeration date
02/08/2019
Last updated
03/24/2026
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