Provider Demographics
NPI:1568548881
Name:COLAN, NEIL BRIAN (EDD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:BRIAN
Last Name:COLAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:READFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04355-3342
Mailing Address - Country:US
Mailing Address - Phone:207-685-3078
Mailing Address - Fax:207-685-3007
Practice Address - Street 1:93 SECOND ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1450
Practice Address - Country:US
Practice Address - Phone:207-626-0025
Practice Address - Fax:207-685-3007
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist