Provider Demographics
NPI:1437873833
Name:FORESTER-CLARKE, COLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:FORESTER-CLARKE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MILTON AVE # 1
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1923
Mailing Address - Country:US
Mailing Address - Phone:802-535-2899
Mailing Address - Fax:
Practice Address - Street 1:7000 COLLAMER RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9764
Practice Address - Country:US
Practice Address - Phone:315-656-7218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist