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NPI Code Detail

MEDICARE: MR. BRYAN JARRED COLE LMFT

MEDICARE: MR. BRYAN JARRED COLE LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist2141MN

General Provider Information

NPI Number : 1053726117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN JARRED COLE LMFT
Provider Business Mailing Address
First Line : 2001 BEAM AVE
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1401
Country : US
Telephone Number : 952-737-4520
Fax Number :
Provider Business Practice Location Address
First Line : 2001 BEAM AVE
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1401
Country : US
Telephone Number : 952-737-4520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2014
Last Update Date : 06/17/2024

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Directions to “ MR. BRYAN JARRED COLE LMFT” Practice Location

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