Provider Demographics
NPI:1366125957
Name:COLTER, DION (LIFE COACH)
Entity type:Individual
Prefix:
First Name:DION
Middle Name:
Last Name:COLTER
Suffix:
Gender:M
Credentials:LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 W SHUMWAY FARM RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6398
Mailing Address - Country:US
Mailing Address - Phone:602-762-3305
Mailing Address - Fax:
Practice Address - Street 1:3009 W SHUMWAY FARM RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6398
Practice Address - Country:US
Practice Address - Phone:602-762-3305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor