Provider Demographics
NPI:1679440895
Name:DYKES, COLETTA
Entity type:Individual
Prefix:
First Name:COLETTA
Middle Name:
Last Name:DYKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COLETTA
Other - Middle Name:
Other - Last Name:ONE VIRTUAL SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:544 CLIFTON BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-2220
Mailing Address - Country:US
Mailing Address - Phone:419-486-9384
Mailing Address - Fax:
Practice Address - Street 1:544 CLIFTON BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-2220
Practice Address - Country:US
Practice Address - Phone:419-486-9384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty