Healthcare Provider Details

I. General information

NPI: 1346780376
Provider Name (Legal Business Name): KIANA LISSETTE COLAS MED, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIANA ESPINAL

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 THORNALL ST STE 550
EDISON NJ
08837-2271
US

IV. Provider business mailing address

343 THORNALL ST
EDISON NJ
08837-2206
US

V. Phone/Fax

Practice location:
  • Phone: 732-724-5883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44963
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: