Individual
MRS. TAMMY KAY COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 MORGANTOWN AVE, FAIRMONT, WV 26554-4511
(304) 816-7691
Mailing address
1605 MORGANTOWN AVE, FAIRMONT, WV 26554-4511
(304) 816-7691
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
E838835
WV
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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