Provider Demographics
NPI:1275126203
Name:COLES, ROSINA
Entity Type:Individual
Prefix:
First Name:ROSINA
Middle Name:
Last Name:COLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 HAMPDEN CT
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2944
Mailing Address - Country:US
Mailing Address - Phone:216-214-7545
Mailing Address - Fax:
Practice Address - Street 1:12305 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2359
Practice Address - Country:US
Practice Address - Phone:216-451-5020
Practice Address - Fax:216-916-4925
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator