Individual
LISSA LYNN COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6692 SPRING ARBOR RD, JACKSON, MI 49201-9322
(517) 795-5191
Mailing address
6692 SPRING ARBOR RD, JACKSON, MI 49201-9322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013670
MI
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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