Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1261 | NC |
NPI | 1073638771 |
---|---|
Provider Name | Ms. Janice Elaine Cole |
First Address | Bryson City, NC 28713-7920 |
Second Address | Asheville, NC 28804-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046PJ | BCBS IND. # (01) | NC |