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General NPI Number Information
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NPI Number | 1578640942
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH COLIS SR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 215 HIGHLAND AVE STE C
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City | HADDON TOWNSHIP
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State | NJ
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Zip | 08108-2634
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Country | US
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Telephone | 856-310-9696
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Fax | 856-854-0992
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Provider Business Mailing Address
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Address Line | 215 HIGHLAND AVE STE C
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City | HADDON TOWNSHIP
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State | NJ
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Zip | 08108-2634
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Country | US
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Telephone | 856-310-9696
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Fax | 856-854-0992
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | NJ1599
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | NJ1599
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License Number State | NJ
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