Provider Demographics
NPI:1093755647
Name:COLE, MARLA MERCER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:MERCER
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 N PORTLAND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6170
Mailing Address - Country:US
Mailing Address - Phone:405-973-4129
Mailing Address - Fax:405-495-9020
Practice Address - Street 1:4911 N PORTLAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6170
Practice Address - Country:US
Practice Address - Phone:405-973-4129
Practice Address - Fax:405-495-9020
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3114101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional