Provider Demographics
NPI:1528139573
Name:COLE, ABBY GOLOMB (PHD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:GOLOMB
Last Name:COLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WELLES ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2080
Mailing Address - Country:US
Mailing Address - Phone:860-659-0191
Mailing Address - Fax:
Practice Address - Street 1:36 WELLES ST STE 210
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2080
Practice Address - Country:US
Practice Address - Phone:860-659-0191
Practice Address - Fax:860-659-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical