Individual
DANIELLE MARIE KOLB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
325 6TH AVE, SOUTH CHARLESTON, WV 25303-1231
(304) 720-3383
Mailing address
117 CIRCLE DR, CROSS LANES, WV 25313-1310
(304) 720-3383
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-19-10593
WV
106S00000X
Behavior Technician
RBT-16-19089
WV
Other
Enumeration date
02/14/2019
Last updated
12/30/2019
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