Individual
ANN MARIE COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
(601) 255-5264
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
(601) 255-5204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-161925
MS
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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