Individual
SERENA COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 S CENTER ST, MOUNT OLIVE, NC 28365
(919) 635-3344
Mailing address
3628 PREACHER HENRY RD, FAISON, NC 28341-6672
(910) 214-9297
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13-4312307
—
NC
Enumeration date
05/27/2018
Last updated
06/01/2018
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