Individual
ANDREA COLAIACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
77 N MAIN ST, GREENVILLE, PA 16125-1781
(724) 588-6490
(724) 588-6475
Mailing address
2201 E STATE ST, HERMITAGE, PA 16148-2727
(724) 981-7141
(724) 981-7148
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000380 CCC'S #
—
PA
Enumeration date
08/27/2008
Last updated
08/27/2008
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