Provider Demographics
NPI:1699342253
Name:VARI, COLTON JAMES
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:JAMES
Last Name:VARI
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 1:9623 GERST RD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9702
Mailing Address - Country:US
Mailing Address - Phone:410-615-6501
Mailing Address - Fax:
Practice Address - Street 1:9623 GERST RD
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9702
Practice Address - Country:US
Practice Address - Phone:410-615-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty