Individual
JESSICA MARIE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 BLAND ST, BLUEFIELD, WV 24701-3030
(304) 787-8255
Mailing address
500 BLAND ST, BLUEFIELD, WV 24701-3030
(304) 787-8255
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
2396
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005489001
—
WV
05
—
0005489002
—
WV
Enumeration date
06/30/2017
Last updated
12/27/2019
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