Provider Demographics
NPI:1417519497
Name:COILE, GLORIA (HAD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:COILE
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 FORSYTH RD STE 120
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4465
Mailing Address - Country:US
Mailing Address - Phone:478-216-5169
Mailing Address - Fax:
Practice Address - Street 1:4646 FORSYTH RD STE 120
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4465
Practice Address - Country:US
Practice Address - Phone:478-216-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HADS000265237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist