Provider Demographics
NPI:1942601521
Name:COLE, COLLEEN ERIN (LAC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ERIN
Last Name:COLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WILLOW DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7078
Mailing Address - Country:US
Mailing Address - Phone:919-260-4844
Mailing Address - Fax:
Practice Address - Street 1:901 WILLOW DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7078
Practice Address - Country:US
Practice Address - Phone:919-260-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC770171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist