Provider Demographics
NPI:1376806174
Name:COLE, BRITTANY K (COTA)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:K
Last Name:COLE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13543 BEATTY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:IN
Mailing Address - Zip Code:47020-9455
Mailing Address - Country:US
Mailing Address - Phone:812-528-5895
Mailing Address - Fax:
Practice Address - Street 1:112 HOLT DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3873
Practice Address - Country:US
Practice Address - Phone:812-265-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002184A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist