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General NPI Number Information
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NPI Number | 1639269715
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Entity Type | Individual
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Provider Name | THERESA KAY COLE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2212 NW 50TH ST SUITE 246C
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-8086
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Country | US
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Telephone | 405-879-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 8717 NW 117TH CT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-1070
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Country | US
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Telephone | 405-773-1793
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 3266-P
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License Number State | OK
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