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Individual

DR. JACK A COLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD.

Contact information

Practice address
302 S KITCHELL AVE, OLNEY, IL 62450-1500
(618) 395-6261
Mailing address
302 S. KITCHELL AVENUE, OLNEY, IL 62450
(618) 395-6261

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
20042023A
IN
103TC0700X
Clinical Psychologist
Primary
IL

Other

Enumeration date
02/27/2006
Last updated
11/09/2007
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