Provider Demographics
NPI:1902687056
Name:COLTER, AUBREY FAITH
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:FAITH
Last Name:COLTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 SMITH ST APT 404
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1360
Mailing Address - Country:US
Mailing Address - Phone:810-938-8172
Mailing Address - Fax:
Practice Address - Street 1:303 SMITH ST APT 404
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-1360
Practice Address - Country:US
Practice Address - Phone:810-938-8172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst