Provider Demographics
NPI:1306673587
Name:COLE, KATHERINE ALICE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ALICE
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 1:78 DONALD ST APT 47
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-3929
Mailing Address - Country:US
Mailing Address - Phone:260-888-0007
Mailing Address - Fax:
Practice Address - Street 1:101 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5011
Practice Address - Country:US
Practice Address - Phone:781-551-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist