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General NPI Number Information
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NPI Number | 1316693484
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Entity Type | Individual
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Provider Name | JACQUELYN TEMERDIS COLE LMSW, CADC, LADAC
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Gender | Female
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Dates
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Enumeration Date | 02/26/2022
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Last Update Date | 02/26/2022
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Provider Practice Location Address
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Address Line | 2900 S SPRING ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-3165
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Country | US
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Telephone | 501-838-0883
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Fax | 682-206-3447
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Provider Business Mailing Address
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Address Line | 2900 S SPRING ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-3165
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Country | US
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Telephone | 501-838-0883
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 416-L
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License Number State | AR
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