Individual
AUTUMN V COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LP LICSW
Contact information
Practice address
624 S 13TH ST, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Mailing address
624 S 13TH ST, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP2216
MN
1041C0700X
Clinical Social Worker
Primary
LICSW7953
MN
Other
Enumeration date
09/29/2006
Last updated
09/11/2025
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