Doctor Name: | JENNIFER L COLE |
NPI Number: | 1073618757 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OT |
License Number: | 102056 |
Business Practice Address: | 675 E Nicollet Blvd #225 Burnsville, MN - 553376700 |
Business Phone Number: | 9528922661 |
Business Fax Number: | |
Mailing Address: | 4090 Oakbrooke Alcove, EAGAN |
State: | MN |
Postal Code: | 551225503 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225XH1200X |
License Number: | 102056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Occupational Therapist |
Taxonomy Specialization: | Hand |
Taxonomy Definition: |