Individual
LAURA A COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1870 SW BESRA DR, MOUNTAIN HOME, ID 83647-1010
(406) 860-7068
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1061072
ID
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-64384
MT
Other
Enumeration date
02/11/2022
Last updated
02/08/2025
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