Individual
MRS. KATHLEEN DIANE COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
26409 FAIRGATE AVE, NEWHALL, CA 91321-2208
(661) 252-7618
Mailing address
26409 FAIRGATE AVE, NEWHALL, CA 91321-2208
(661) 252-7618
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 2461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMS169422
OT PEDS
CA
Enumeration date
01/15/2007
Last updated
07/08/2007
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