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General NPI Number Information
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NPI Number | 1841046158
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Entity Type | Individual
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Provider Name | ANNA COLE
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Gender | Female
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 10257 IL-3
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City | RED BUD
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State | IL
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Zip | 62278
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Country | US
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Telephone | 618-282-6233
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Fax |
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Provider Business Mailing Address
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Address Line | 421 BEM ST
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City | CHESTER
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State | IL
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Zip | 62233-1027
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Country | US
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Telephone | 618-615-8244
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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