Provider Demographics
NPI:1114696358
Name:KOLARZ, JILLIAN (LCAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:KOLARZ
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6370
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-0370
Mailing Address - Country:US
Mailing Address - Phone:518-516-1080
Mailing Address - Fax:518-516-1070
Practice Address - Street 1:188 S 3RD ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1801
Practice Address - Country:US
Practice Address - Phone:315-537-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist