Provider Demographics
NPI:1316207509
Name:COLEY, COLLEEN ELIZABETH (MS, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:COLEY
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:233 S WACKER DR
Mailing Address - Street 2:84TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-7147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8833 GROSS POINT RD
Practice Address - Street 2:STE. 309
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1859
Practice Address - Country:US
Practice Address - Phone:317-441-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst