Provider Demographics
NPI:1285914226
Name:COLE, EMILY (MED)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:STOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:100 CHESTNUT ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1455
Mailing Address - Country:US
Mailing Address - Phone:325-676-8963
Mailing Address - Fax:
Practice Address - Street 1:100 CHESTNUT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1455
Practice Address - Country:US
Practice Address - Phone:325-676-8963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional