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Individual

KIMBERLY COLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1451 MANOR BLVD, WILLIAMSBURG, VA 23185-2843
(757) 707-3374
(757) 707-3374
Mailing address
PO BOX 6364, WILLIAMSBURG, VA 23188-5222
(757) 707-3374
(757) 707-3374

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0592812595
VA
Enumeration date
12/10/2018
Last updated
12/10/2018
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