Provider Demographics
NPI:1659797884
Name:KOLIAS, ANASTASIA ATHANASIA (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ANASTASIA
Middle Name:ATHANASIA
Last Name:KOLIAS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22436 NONA ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2723
Mailing Address - Country:US
Mailing Address - Phone:313-580-8868
Mailing Address - Fax:
Practice Address - Street 1:3471 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8552
Practice Address - Country:US
Practice Address - Phone:313-580-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst