Individual
NICOLE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
495 E WHITBECK ST, KUNA, ID 83634-5117
(360) 480-4147
Mailing address
495 E WHITBECK ST, KUNA, ID 83634-5117
(360) 480-4147
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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