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NPI Code Detail

MEDICARE: MRS. MARLA MERCER COLE LPC

MEDICARE: MRS. MARLA MERCER COLE LPC
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
1101YP2500XProfessional Counselor3114OK

General Provider Information

NPI Number : 1093755647
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARLA MERCER COLE LPC
Provider Business Mailing Address
First Line : 4911 N PORTLAND AVE
Second Line : SUITE 105
City : OKLAHOMA CITY
State : OK
Zip : 73112-6170
Country : US
Telephone Number : 405-973-4129
Fax Number : 405-495-9020
Provider Business Practice Location Address
First Line : 4911 N PORTLAND AVE
Second Line : SUITE 105
City : OKLAHOMA CITY
State : OK
Zip : 73112-6170
Country : US
Telephone Number : 405-973-4129
Fax Number : 405-495-9020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 07/08/2007

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