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NPI Code Detail

MEDICARE: GREGORY MARTIN COLE

MEDICARE: GREGORY MARTIN COLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1598003949
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY MARTIN COLE
Provider Business Mailing Address
First Line : 1722 PRIMROSE PATH
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-1918
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1722 PRIMROSE PATH
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-1918
Country : US
Telephone Number : 702-515-7117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2013
Last Update Date : 01/18/2013

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Directions to “ GREGORY MARTIN COLE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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