Provider Demographics
NPI:1639224751
Name:COLE, SANDRA WILLIAMS
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:WILLIAMS
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 1:309 IRWIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1282
Mailing Address - Country:US
Mailing Address - Phone:907-762-8665
Mailing Address - Fax:907-562-7901
Practice Address - Street 1:2735 E TUDOR RD
Practice Address - Street 2:ANCHORAGE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1135
Practice Address - Country:US
Practice Address - Phone:907-762-8665
Practice Address - Fax:907-562-7901
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor