Provider Demographics
NPI:1437827706
Name:SANCHEZ, KOLBY (S/T, MA)
Entity Type:Individual
Prefix:
First Name:KOLBY
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:S/T, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-3014
Mailing Address - Country:US
Mailing Address - Phone:706-957-1154
Mailing Address - Fax:
Practice Address - Street 1:122 GORDON COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-5754
Practice Address - Country:US
Practice Address - Phone:706-845-4054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health