Healthcare Provider Details

I. General information

NPI: 1003720129
Provider Name (Legal Business Name): MISS ANNELIESE CLAIRE KOLASKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 N SANDUSKY ST STE 300
DELAWARE OH
43015-1755
US

IV. Provider business mailing address

12 HAWKSMOOR DR
NEW ALBANY OH
43054-8183
US

V. Phone/Fax

Practice location:
  • Phone: 614-425-2310
  • Fax:
Mailing address:
  • Phone: 614-746-6857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: