| Doctor Name: | MISS IVANA COLES |
| NPI Number: | 1073959417 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | |
| Business Practice Address: | 541 Main St Suite 303 Weymouth, MA - 021901868 |
| Business Phone Number: | 7813317866 |
| Business Fax Number: | |
| Mailing Address: | 24 Murdock St, Apt 4 BRIGHTON |
| State: | MA |
| Postal Code: | 021352864 |
| Phone Number: | 6178668212 |
| Fax Number: | |
| NPI Enumeration Date: | 05/13/2013 |
| NPI Last Update Date: | 05/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |