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Individual

MRS. MANDILYN MARIE COLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
4850 WHIPPOORWILL DR, LAFAYETTE, IN 47909
(765) 714-5004
(765) 538-2205
Mailing address
4850 WHIPPOORWILL DR, LAFAYETTE, IN 47909
(765) 538-2205
(765) 538-2205

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003885A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2004138
IN
Enumeration date
10/24/2006
Last updated
07/08/2007
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