Individual
COLTEN JEFFERSON TEX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4897
(216) 320-8222
(216) 932-6704
Mailing address
12000 FAIRHILL RD APT 204, CLEVELAND, OH 44120-1052
(309) 201-9710
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2410616
OH
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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