Provider Demographics
NPI:1295625333
Name:COLEY, MARQUES ANDRE
Entity type:Individual
Prefix:
First Name:MARQUES
Middle Name:ANDRE
Last Name:COLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 SUMMIT DRIVE
Mailing Address - Street 2:MCOLEY@CNSHEALTHCARE.ORG
Mailing Address - City:WATERFORD 48328
Mailing Address - State:MI
Mailing Address - Zip Code:48328-1766
Mailing Address - Country:US
Mailing Address - Phone:248-222-2740
Mailing Address - Fax:
Practice Address - Street 1:279 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3364
Practice Address - Country:US
Practice Address - Phone:248-222-2740
Practice Address - Fax:248-222-2740
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist