Individual
ALPHONSO COLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
142 GRIGGS ST, WATERBURY, CT 06704-3110
(203) 574-1419
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000373
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/13/2008
Last updated
03/24/2023
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