Provider Demographics
NPI:1417014630
Name:KOLO, NANCY (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KOLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 TURTLE CREEK BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5426
Mailing Address - Country:US
Mailing Address - Phone:972-948-9155
Mailing Address - Fax:214-443-0322
Practice Address - Street 1:3131 TURTLE CREEK BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5426
Practice Address - Country:US
Practice Address - Phone:972-948-9155
Practice Address - Fax:214-443-0322
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128151OtherVALUE OPTIONS