Individual
JACESON COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
533 8TH AVE #1024, OURAY, CO 81427-8142
(318) 491-1619
Mailing address
PO BOX 1024, OURAY, CO 81427-1024
(318) 491-1619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09924580
CO
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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