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General NPI Number Information
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NPI Number | 1073993143
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Entity Type | Individual
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Provider Name | SADIE H COLE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1115 MAPLE WAY, SUITE D P.O. BOX 13129
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City | JACKSON
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State | WY
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Zip | 83002
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Country | US
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Telephone | 215-880-0413
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Fax | 978-405-7019
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Provider Business Mailing Address
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Address Line | PO BOX 13129 1115 MAPLE WAY SUITE D
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City | JACKSON
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State | WY
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Zip | 83002
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Country | US
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Telephone | 215-880-0413
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 631
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10138
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License Number State | MA
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