Provider Demographics
NPI:1073159109
Name:COLE, ASHLEIGH MARLENE
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:MARLENE
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10262 TIMBER MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-7002
Mailing Address - Country:US
Mailing Address - Phone:231-499-6222
Mailing Address - Fax:
Practice Address - Street 1:10262 TIMBER MEADOWS DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-7002
Practice Address - Country:US
Practice Address - Phone:231-499-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician