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General NPI Number Information
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NPI Number | 1801475140
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Entity Type | Individual
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Provider Name | COLLEEN COCHRANE LLMSW
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 677 E MAIN ST
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City | CENTREVILLE
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State | MI
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Zip | 49032-8524
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Country | US
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Telephone | 269-467-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 5910 LOVERS LN
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City | PORTAGE
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State | MI
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Zip | 49002-1607
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Country | US
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Telephone | 269-275-9903
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801108346
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851108346
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License Number State | MI
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