Provider Demographics
NPI:1659671592
Name:KOLB, ANN MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:KOLB
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 1:961 MARCON BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9373
Mailing Address - Country:US
Mailing Address - Phone:610-266-0610
Mailing Address - Fax:610-266-0292
Practice Address - Street 1:961 MARCON BLVD STE 312
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9373
Practice Address - Country:US
Practice Address - Phone:610-266-0610
Practice Address - Fax:610-266-0292
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health