Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003230210 |
---|---|
Provider Name | Rivette Cole |
First Address | Fayetteville, NC 28306-4592 |
Second Address | Fayetteville, NC 28306-4952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2014 |
Last Update Date | 02/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P007442 | NCSWB (01) | NC |