Individual
SAMANTHA JEAN COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8049 KENSINGTON BLVD APT 70, DAVISON, MI 48423-2294
(810) 336-0736
Mailing address
8049 KENSINGTON BLVD APT 70, DAVISON, MI 48423-2294
(810) 336-0736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007042420
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/08/2019
Last updated
01/08/2019
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