Provider Demographics
NPI:1285798611
Name:COX-KOLEK, MARLAE ROBIN (MS, LADC, LPC)
Entity Type:Individual
Prefix:
First Name:MARLAE
Middle Name:ROBIN
Last Name:COX-KOLEK
Suffix:
Gender:F
Credentials:MS, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3681
Mailing Address - Country:US
Mailing Address - Phone:507-345-4448
Mailing Address - Fax:507-625-1000
Practice Address - Street 1:209 S BROAD ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3681
Practice Address - Country:US
Practice Address - Phone:507-345-4448
Practice Address - Fax:507-625-1000
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN300331101YA0400X
MN00038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional