Doctor Name: | JEAN BULLOCK COLE |
NPI Number: | 1053413245 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 9395 Crown Crest Blvd Parker, CO - 80138 |
Business Phone Number: | 3032694590 |
Business Fax Number: | |
Mailing Address: | Dept 1762, DENVER |
State: | CO |
Postal Code: | 802911762 |
Phone Number: | 3034865504 |
Fax Number: | 3034865501 |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |