Individual
DENITRA COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1455 N LAKELAND DR, MERIDIAN, MS 39307-9020
(601) 581-0120
Mailing address
729 ALAMUTCHA ST, APT B, MARION, MS 39342-9718
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2217
MS
Other
Enumeration date
03/17/2009
Last updated
03/17/2009
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