Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 590 | NH |
Y | 101YP2500X | Professional Counselor | CC2671 | ME |
NPI | 1003005604 |
---|---|
Provider Name | Ms. Christy Ann Cole |
First Address | Kennebunk, ME 04043-7759 |
Second Address | Kennebunk, ME 04043-7759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 26/07/2021 |